Death related to Cedecea lapagei in a soft tissue bullae infection: a case report
Abstract Background Cedecea lapagei bacterium was discovered in 1977 but was not known to be pathogenic to humans until 2006. In the medical literature there are very few clinical case reports of Cedecea lapagei; none have reported a catastrophic death secondary to a soft tissue hemorrhagic bullae i...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2018-11-01
|
| Series: | Journal of Medical Case Reports |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13256-018-1866-x |
| _version_ | 1818135585829683200 |
|---|---|
| author | Victor Ramzes Chavez Herrera Maria Fernanda Rosas De Silva Homero Orendain Alcaraz Gabriel Ceja Espiritu Karla Carrazco Peña Valery Melnikov |
| author_facet | Victor Ramzes Chavez Herrera Maria Fernanda Rosas De Silva Homero Orendain Alcaraz Gabriel Ceja Espiritu Karla Carrazco Peña Valery Melnikov |
| author_sort | Victor Ramzes Chavez Herrera |
| collection | DOAJ |
| description | Abstract Background Cedecea lapagei bacterium was discovered in 1977 but was not known to be pathogenic to humans until 2006. In the medical literature there are very few clinical case reports of Cedecea lapagei; none have reported a catastrophic death secondary to a soft tissue hemorrhagic bullae infection. As well as soft tissue infection, rare cases of pneumonia, urinary tract infections, peritonitis, osteomyelitis, bacteremia, and sepsis have been documented with the majority having good outcomes. Here, we present the first case of a fatal outcome in a Cedecea lapagei soft tissue infection with multiple hemorrhagic bullae. Case presentation A 52-year-old Mexican man with antecedents of liver cirrhosis and treated hypertension was brought to our institution with clinical signs of sepsis and 16 to 18 hours of history of pain and edema in his right lower limb. During the course of the first day hospitalized in our institution, he developed several large serohematogenous bullae with ascending progression on his entire right lower limb. He subsequently developed multiple organ failure and septic shock with rapid deterioration, dying on the second day. Bullae fluid samples taken the first day undoubtedly isolated Cedecea lapagei within the second day using MicroScan WalkAway® 96 plus System as well Gram-negative bacteria in MacConkey and blood agar. Conclusions The isolation of Cedecea lapagei was an unexpected etiological finding that will enable physicians in the future to consider this bacterium as a probable cause of serohematogenous bullae infections. We do not exclude contamination although it has never been isolated in bullae fluid in the medical literature. Future encounters with this bacterium should not be taken lightly as it may have the potential to have fatal outcomes. |
| first_indexed | 2024-12-11T09:26:51Z |
| format | Article |
| id | doaj.art-ef5c3e2033a24e68830f113c52423a69 |
| institution | Directory Open Access Journal |
| issn | 1752-1947 |
| language | English |
| last_indexed | 2024-12-11T09:26:51Z |
| publishDate | 2018-11-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Medical Case Reports |
| spelling | doaj.art-ef5c3e2033a24e68830f113c52423a692022-12-22T01:13:08ZengBMCJournal of Medical Case Reports1752-19472018-11-011211510.1186/s13256-018-1866-xDeath related to Cedecea lapagei in a soft tissue bullae infection: a case reportVictor Ramzes Chavez Herrera0Maria Fernanda Rosas De Silva1Homero Orendain Alcaraz2Gabriel Ceja Espiritu3Karla Carrazco Peña4Valery Melnikov5Instituto Mexicano de Seguro Social, General Hospital Zona #1, University of Colima, Faculty of MedicineInstituto Mexicano de Seguro Social, General Hospital Zona #1, University of Colima, Faculty of MedicineInstituto Mexicano de Seguro Social, General Hospital Zona #1Instituto Mexicano de Seguro Social, General Hospital Zona #1, University of Colima, Faculty of MedicineFaculty of Medicine, University of ColimaFaculty of Medicine, University of ColimaAbstract Background Cedecea lapagei bacterium was discovered in 1977 but was not known to be pathogenic to humans until 2006. In the medical literature there are very few clinical case reports of Cedecea lapagei; none have reported a catastrophic death secondary to a soft tissue hemorrhagic bullae infection. As well as soft tissue infection, rare cases of pneumonia, urinary tract infections, peritonitis, osteomyelitis, bacteremia, and sepsis have been documented with the majority having good outcomes. Here, we present the first case of a fatal outcome in a Cedecea lapagei soft tissue infection with multiple hemorrhagic bullae. Case presentation A 52-year-old Mexican man with antecedents of liver cirrhosis and treated hypertension was brought to our institution with clinical signs of sepsis and 16 to 18 hours of history of pain and edema in his right lower limb. During the course of the first day hospitalized in our institution, he developed several large serohematogenous bullae with ascending progression on his entire right lower limb. He subsequently developed multiple organ failure and septic shock with rapid deterioration, dying on the second day. Bullae fluid samples taken the first day undoubtedly isolated Cedecea lapagei within the second day using MicroScan WalkAway® 96 plus System as well Gram-negative bacteria in MacConkey and blood agar. Conclusions The isolation of Cedecea lapagei was an unexpected etiological finding that will enable physicians in the future to consider this bacterium as a probable cause of serohematogenous bullae infections. We do not exclude contamination although it has never been isolated in bullae fluid in the medical literature. Future encounters with this bacterium should not be taken lightly as it may have the potential to have fatal outcomes.http://link.springer.com/article/10.1186/s13256-018-1866-xHemorrhagic bullaeCedecea lapageiCedeceaSoft tissue infection |
| spellingShingle | Victor Ramzes Chavez Herrera Maria Fernanda Rosas De Silva Homero Orendain Alcaraz Gabriel Ceja Espiritu Karla Carrazco Peña Valery Melnikov Death related to Cedecea lapagei in a soft tissue bullae infection: a case report Journal of Medical Case Reports Hemorrhagic bullae Cedecea lapagei Cedecea Soft tissue infection |
| title | Death related to Cedecea lapagei in a soft tissue bullae infection: a case report |
| title_full | Death related to Cedecea lapagei in a soft tissue bullae infection: a case report |
| title_fullStr | Death related to Cedecea lapagei in a soft tissue bullae infection: a case report |
| title_full_unstemmed | Death related to Cedecea lapagei in a soft tissue bullae infection: a case report |
| title_short | Death related to Cedecea lapagei in a soft tissue bullae infection: a case report |
| title_sort | death related to cedecea lapagei in a soft tissue bullae infection a case report |
| topic | Hemorrhagic bullae Cedecea lapagei Cedecea Soft tissue infection |
| url | http://link.springer.com/article/10.1186/s13256-018-1866-x |
| work_keys_str_mv | AT victorramzeschavezherrera deathrelatedtocedecealapageiinasofttissuebullaeinfectionacasereport AT mariafernandarosasdesilva deathrelatedtocedecealapageiinasofttissuebullaeinfectionacasereport AT homeroorendainalcaraz deathrelatedtocedecealapageiinasofttissuebullaeinfectionacasereport AT gabrielcejaespiritu deathrelatedtocedecealapageiinasofttissuebullaeinfectionacasereport AT karlacarrazcopena deathrelatedtocedecealapageiinasofttissuebullaeinfectionacasereport AT valerymelnikov deathrelatedtocedecealapageiinasofttissuebullaeinfectionacasereport |