Upper extremity myonecrosis caused by Edwardsiella tarda resulting in transhumeral amputation: case report

J Hand Surg Am. 2013 Jan;38(1):129-32. doi: 10.1016/j.jhsa.2012.10.009. Epub 2012 Nov 30.

Abstract

Necrotizing soft tissue infections are rapidly progressive infections with a high rate of mortality. One type of necrotizing soft tissue infection is caused by marine gram-negative bacteria and commonly occurs in immunocompromised hosts. These types of infections are more common in patients with chronic liver disease, possibly because of impaired iron metabolism. We present the case of a rapidly progressive necrotizing soft tissue infection caused by Edwardsiella tarda, a marine gram-negative pathogen common in catfish. Few extraintestinal infections of E tarda have been described previously. Our patient had hepatitis C and was exposed to the bacteria by a puncture injury from a wild catfish. His infection required multiple debridements and ultimately required a transhumeral amputation for local control of the infection.

Publication types

  • Case Reports

MeSH terms

  • Amputation, Surgical*
  • Animals
  • Anti-Bacterial Agents / administration & dosage
  • Catfishes
  • Ceftriaxone / administration & dosage
  • Comorbidity
  • Debridement
  • Disease Progression
  • Edwardsiella tarda*
  • Enterobacteriaceae Infections / complications*
  • Enterobacteriaceae Infections / epidemiology
  • Enterobacteriaceae Infections / surgery
  • Fascia / pathology
  • Hand Injuries / complications
  • Hand Injuries / microbiology*
  • Hand Injuries / pathology
  • Hepatitis C / epidemiology
  • Humans
  • Male
  • Middle Aged
  • Muscle, Skeletal / pathology*
  • Necrosis
  • Soft Tissue Infections / epidemiology
  • Soft Tissue Infections / microbiology*
  • Soft Tissue Infections / surgery
  • Upper Extremity / pathology
  • Wounds, Penetrating / complications
  • Wounds, Penetrating / microbiology*
  • Wounds, Penetrating / surgery

Substances

  • Anti-Bacterial Agents
  • Ceftriaxone