An Unusual Encounter: Aeromonas veronii Infection in a Case of Ulcerative Colitis

Aeromonas veronii-associated ulcerative colitis flare is sparsely reported in the literature but is a treatable condition with antibiotics including trimethoprim/sulfamethoxazole (TMP-SMX), fluoroquinolones, and second/third-generation cephalosporins. We report a case of a patient with long-standing ulcerative colitis (UC), who presented with bloody stools, fatigue, and oliguria that did not respond to standard regimen including steroids. The lab finding was significant for leukocytosis and anemia. A. veronii was cultured in the stool specimens. The patient was started on ciprofloxacin with marked improvement of symptoms on the second day of initiation of the antibiotic. Although rare, a possible Aeromonas infection should be suspected in patients presenting with a flare of ulcerative colitis. A prompt initiation of treatment can provide rapid improvement in clinical status of these patients.