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Aeromonas septicemia in infants and children
Insights
Aeromonas septicemia is a severe infection in children, often occurring in those with underlying health issues. This review highlights a 50% fatality rate, particularly in leukemia and aplastic anemia patients.
Area of Science:
- Pediatric Infectious Diseases
- Bacteriology
Background:
- Aeromonas septicemia is an uncommon but severe bloodstream infection.
- This study reviews cases in pediatric patients at Ramathibodi Hospital.
Observation:
- Twenty infants and children (1 day to 14 years) with Aeromonas septicemia were analyzed.
- Eighteen patients had significant underlying conditions, including leukemia, aplastic anemia, cirrhosis, and thalassemia.
- Aeromonas hydrophila was identified in all blood cultures; four cases involved polymicrobial bacteremia.
Findings:
- The majority of septicemia episodes (15) were community-acquired.
- Clinical presentations were similar to other Gram-negative enteric bacillus septicemia.
- Severe complications included ecthyma gangrenosum, necrotizing fasciitis, and meningitis in some patients.
- The overall case fatality rate was 50%, with a higher mortality (8/9) in patients with acute leukemia or aplastic anemia.
Implications:
- Aeromonas septicemia poses a significant threat, especially to immunocompromised children.
- Prompt diagnosis and appropriate antibiotic therapy are crucial for improving outcomes.
- Further research into risk factors and treatment strategies for Aeromonas septicemia in pediatric populations is warranted.
Abstract:
Our experience at the Ramathibodi Hospital with 20 infants and children who had Aeromonas septicemia is reviewed. Their ages were from 1 day to 14 years. Eighteen patients had underlying diseases: leukemia, 5; aplastic anemia, 4; cirrhosis, 2; thalassemia/hemoglobinopathy, 3; renal failure, 1; ileal perforation, 1; marasmus, 1; and cavernous hemangioma with thrombocytopenia, 1. Blood cultures yielded Aeromonas hydrophila in all patients, and four patients had polymicrobial bacteremia. Fifteen episodes of septicemia were community-acquired and five were hospital-acquired. The clinical manifestations of these patients were similar to septicemia due to other Gram-negative enteric bacilli. Two patients each had ecthyma gangrenosum, necrotizing fasciitis and meningitis. Antibiotic treatment included penicillins, cephalosporins, aminoglycosides and sulfamethoxazole-trimethoprim. The overall case fatality rate was 50%; eight of the nine patients with acute leukemia or aplastic anemia died. With the exception of one child the blood cultures were sterile in all patients before death. Aeromonas septicemia is an uncommon but severe infection which occurs predominantly in compromised hosts.