Related Experiment Videos
Skin and soft-tissue manifestations of Shewanella putrefaciens infection
1Department of Internal Medicine, Veterans General Hospital-Kaohsiung, Taiwan, Republic of China.
Abstract:
Shewanella putrefaciens, a saprophytic gram-negative rod, is infrequently recovered from clinical specimens. Although a number of clinical syndromes have been attributed to S. putrefaciens, the pathogenic role of this agent remains largely undefined. We report 16 cases of S. putrefaciens infection that occurred at the Veterans General Hospital-Kaohsiung in Taiwan between 1990 and 1995. S. putrefaciens infection was associated with a wide clinical spectrum including bacteremia/septicemia, skin and soft-tissue infection, biliary tract infection, peritonitis, and empyema. Five of our patients had skin and soft-tissue manifestations, including fulminant periorbitofacial cellulitis, dacryocystitis, perineal abscess, finger abscess, and postcholecystectomy wound infection. These clinical features deviated from the chronic ulcers or infected burns of the lower extremities that have been described in previous reports. Seven (44%) of our 16 patients had bacteremia/septicemia, and all seven had underlying hepatobiliary diseases. S. putrefaciens was isolated in mixed cultures of specimens from 14 patients; Escherichia coli was the most common coisolate. Hepatobiliary diseases and malignancy were the major predisposing factors for S. putrefaciens infection of the biliary tract and S. putrefaciens bacteremia/septicemia.
Insights
Shewanella putrefaciens, a gram-negative bacterium, can cause diverse infections beyond typical skin ulcers. This study details 16 cases, highlighting its role in bacteremia and soft-tissue infections, often linked to hepatobiliary disease.
Area of Science:
- Clinical microbiology
- Infectious diseases
- Bacteriology
Background:
- Shewanella putrefaciens is a saprophytic gram-negative rod rarely found in clinical settings.
- Its pathogenic role in human infections is not well-defined.
Observation:
- A retrospective study identified 16 cases of Shewanella putrefaciens infection between 1990-1995.
- Infections presented with a broad spectrum: bacteremia/septicemia, skin/soft-tissue infections, biliary tract infections, peritonitis, and empyema.
- Observed skin and soft-tissue infections included cellulitis, dacryocystitis, and abscesses, differing from previously reported chronic ulcers.
Findings:
- Seven patients (44%) developed bacteremia/septicemia, all with underlying hepatobiliary diseases.
- Hepatobiliary disease and malignancy were identified as primary predisposing factors for biliary tract infections and bacteremia.
- Shewanella putrefaciens was frequently isolated in mixed cultures, with Escherichia coli being the most common coisolate.
Implications:
- These findings expand the known clinical spectrum of Shewanella putrefaciens infections.
- Highlights the importance of considering Shewanella putrefaciens in patients with hepatobiliary disease, especially those presenting with sepsis or soft-tissue infections.
- Suggests a need for further research into the pathogenicity and treatment of Shewanella putrefaciens infections.