A CASE SERIES OF SHEWANELLA ALGAE BACTEREMIA WITH DIFFERENT OUTCOMES

Intro: Shewanella spp. is increasingly recognized as an emerging pathogen causing skin and soft tissue infection (SSTI). They are found ubiquitously in soil and the aquatic environment, particularly in warmer geographical climates. Methods: We present 2 cases of S. algae infection. The first case in...

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Main Authors: U. Salamah Faisal, F.F. Hamzah, U.A. Zainulabid, D. Hun
Format: Article
Language:English
Published: Elsevier 2023-05-01
Series:International Journal of Infectious Diseases
Online Access:http://www.sciencedirect.com/science/article/pii/S1201971223004381
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author U. Salamah Faisal
F.F. Hamzah
U.A. Zainulabid
D. Hun
author_facet U. Salamah Faisal
F.F. Hamzah
U.A. Zainulabid
D. Hun
author_sort U. Salamah Faisal
collection DOAJ
description Intro: Shewanella spp. is increasingly recognized as an emerging pathogen causing skin and soft tissue infection (SSTI). They are found ubiquitously in soil and the aquatic environment, particularly in warmer geographical climates. Methods: We present 2 cases of S. algae infection. The first case involves a 75- year-old man with underlying chronic lymphocytic leukaemia (CLL) who developed rapidly worsening left-hand cellulitis. S. algae was isolated from cultures of both his blood and right-hand swab. His antibiotics were revised from ampicillin-sulbactam to ceftazidime, and he recovered well after two weeks of intravenous ceftazidime. The second is a fatal case of septic shock due to leg cellulitis with S. algae bacteraemia. Unfortunately, this patient succumbed to his illness within 72 hours of hospital admission. Findings: Both aerobic and anaerobic BACTEC vials were positive. Gram stain showed gram-negative bacteria. After overnight incubation, sheep blood agar shows enormous grey colonies with a yellowish-orange tinge. MacConkey agar showed non-lactose fermenting colonies. The triple sugar iron test showed alkaline butt and slant with considerable hydrogen sulphide formation. Oxidase and motility tests were both positive. Forty-eight hours of incubation on blood agar revealed mucoid colonies with uneven haemolysis. This isolate can grow at 42°C. However, the colonies are smaller than at 37°C. Morphology and biochemistry suggest S. algae. With 99% certainty, Vitek 2 GN identified S. algae. Discussion: Identifying S. algae to its correct speciation is vital in the back of the knowledge that S. algae is considered more virulent than other Shewanella species and warrants more vigilant attention. Early identification of S. algae will also have a crucial impact on the choice of treating antimicrobial. Conclusion: Failure to promptly diagnose and treat this rare pathogen could lead to serious morbidity or death.
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spelling doaj.art-d81cf22747fc40d2a6b925185607ea942023-05-18T04:38:58ZengElsevierInternational Journal of Infectious Diseases1201-97122023-05-01130S125A CASE SERIES OF SHEWANELLA ALGAE BACTEREMIA WITH DIFFERENT OUTCOMESU. Salamah Faisal0F.F. Hamzah1U.A. Zainulabid2D. Hun3Universiti Kebangsaan Malaysia, Medical Microbiology & Immunology, Cheras, MalaysiaUniversiti Kebangsaan Malaysia, Medical Microbiology & Immunology, Cheras, MalaysiaInternational Islamic University Malaysia, Internal Medicine, Kulliyyah of Medicine, Kuantan, Malaysia; Hospital Canselor Tuanku Muhriz UKM, Internal Medicine, Cheras Perdana, MalaysiaUniversiti Kebangsaan Malaysia, Medical Microbiology & Immunology, Cheras, MalaysiaIntro: Shewanella spp. is increasingly recognized as an emerging pathogen causing skin and soft tissue infection (SSTI). They are found ubiquitously in soil and the aquatic environment, particularly in warmer geographical climates. Methods: We present 2 cases of S. algae infection. The first case involves a 75- year-old man with underlying chronic lymphocytic leukaemia (CLL) who developed rapidly worsening left-hand cellulitis. S. algae was isolated from cultures of both his blood and right-hand swab. His antibiotics were revised from ampicillin-sulbactam to ceftazidime, and he recovered well after two weeks of intravenous ceftazidime. The second is a fatal case of septic shock due to leg cellulitis with S. algae bacteraemia. Unfortunately, this patient succumbed to his illness within 72 hours of hospital admission. Findings: Both aerobic and anaerobic BACTEC vials were positive. Gram stain showed gram-negative bacteria. After overnight incubation, sheep blood agar shows enormous grey colonies with a yellowish-orange tinge. MacConkey agar showed non-lactose fermenting colonies. The triple sugar iron test showed alkaline butt and slant with considerable hydrogen sulphide formation. Oxidase and motility tests were both positive. Forty-eight hours of incubation on blood agar revealed mucoid colonies with uneven haemolysis. This isolate can grow at 42°C. However, the colonies are smaller than at 37°C. Morphology and biochemistry suggest S. algae. With 99% certainty, Vitek 2 GN identified S. algae. Discussion: Identifying S. algae to its correct speciation is vital in the back of the knowledge that S. algae is considered more virulent than other Shewanella species and warrants more vigilant attention. Early identification of S. algae will also have a crucial impact on the choice of treating antimicrobial. Conclusion: Failure to promptly diagnose and treat this rare pathogen could lead to serious morbidity or death.http://www.sciencedirect.com/science/article/pii/S1201971223004381
spellingShingle U. Salamah Faisal
F.F. Hamzah
U.A. Zainulabid
D. Hun
A CASE SERIES OF SHEWANELLA ALGAE BACTEREMIA WITH DIFFERENT OUTCOMES
International Journal of Infectious Diseases
title A CASE SERIES OF SHEWANELLA ALGAE BACTEREMIA WITH DIFFERENT OUTCOMES
title_full A CASE SERIES OF SHEWANELLA ALGAE BACTEREMIA WITH DIFFERENT OUTCOMES
title_fullStr A CASE SERIES OF SHEWANELLA ALGAE BACTEREMIA WITH DIFFERENT OUTCOMES
title_full_unstemmed A CASE SERIES OF SHEWANELLA ALGAE BACTEREMIA WITH DIFFERENT OUTCOMES
title_short A CASE SERIES OF SHEWANELLA ALGAE BACTEREMIA WITH DIFFERENT OUTCOMES
title_sort case series of shewanella algae bacteremia with different outcomes
url http://www.sciencedirect.com/science/article/pii/S1201971223004381
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