Meningitis due to carbapenemase-producing Aeromonas hydrophila: a case report

Here we describe an unusual clinical presentation of infection due to Aeromonas hydrophila and underline the importance of a correct microbiological diagnosis for an adequate treatment. A 6-year-old patient with a history of craniotomy with duraplasty the week before consulted for fever and drainage of serosanguineous fluid from the surgical wound. The laboratory parameters were normal and the computed tomography scan showed no relevant changes. Lumbar puncture: leukocytes: 91/mm3; proteins: 89 mg/dL; glucose: 36 mg/dL. Treatment with vancomycin and ceftazidime was started. Cerebrospinal fluid culture: oxidase-positive, glucose-fermenting Gram-negative bacillus. Treatment was changed to meropenem. At 72 hours, using a diffusion method and Vitek 2, it was reported as Aeromonas hydrophila sensitive to trimethoprim-sulfamethoxazole, ciprofloxacin, cefotaxime, and meropenem. The Blue-Carba method was performed to detect carbapenemases; the result was positive. Treatment was changed to trimethoprimsulfamethoxazole. The patient completed 21 days of treatment with a favorable clinical course.