Published online Mar 26, 2019. doi: 10.12998/wjcc.v7.i6.759
Peer-review started: December 12, 2018
First decision: January 5, 2019
Revised: January 21, 2019
Accepted: January 29, 2019
Article in press: January 30, 2019
Published online: March 26, 2019
Aeromonas species are uncommon pathogens in biliary sepsis and cause substantial mortality in patients with impaired hepatobiliary function. Asia has the highest incidence of infection from Aeromonas, whereas cases in the west are rare.
We report the case of a 64-year-old woman with advanced pancreatic cancer and jaundice who manifested fever, abdominal pain, severe thrombocytopenia, anemia and kidney failure following the insertion of a percutaneous transhepatic biliary drainage. Blood culture results revealed the presence of Aeromonas veronii biovar veronii (A. veronii biovar veronii). After antibiotic therapy and transfusions, the life-threatening clinical conditions of the patient improved and she was discharged.
This was a rare case of infection, probably the first to be reported in West countries, caused by A. veronii biovar veronii following biliary drainage. A finding of Aeromonas must alert clinician to the possibility of severe sepsis.
Core tip:Aeromonas infection is fairly infrequent, and cholangitis caused by this species represents around 3% of all cases of bile duct infection. The bacterium appears to have high incidence in Asia. The infection may have a dramatic presentation. Our case report describes one of the few cases of cholangitis by Aeromonas to be reported in Western countries and, in particular, the first to be attributed to Aeromonas veronii biovar veronii after the positioning of biliary drainage. Antibiotic prophylaxis should be considered a priori. The finding of an infection from Aeromonas should alert the clinician to the possibility of severe sepsis.