Infectious Disease Compendium

Aeromonas

Microbiology

Gram negative rod; includes A. caviae, A. hydrophilia, A. salmonicida, A. sobria.

Epidemiologic Risks

Fresh water exposure. It is found in warmer climates, including cases in the Caribbean. It causes bacteremia in patients with underlying medical problems. It is part of the normal flora of leeches, so infections are assoicated with medicinal leeches (used in reattachment of fingers and the like). Even though antibiotics are given with leech therapy, occasionally a resistant organism sneeks in (PubMed).

Syndromes

Colitis sometimes mimicking acute ulcerative colitis, necrotizing soft tissue infection after fresh water trauma, cellulitis often with bacteremia (PubMed) and the usual hodgepodge of focal infections.

In Korea and Taiwan it is a major cause of SBP in cirrhotics (PubMed).

In drowning patients it is the most common cause of pneumonia (PubMed).

Case of recurrent infection traced to well, or not so well, water.  If you ask you will be surprized at the various sources from which people ge their water.

Treatment

Third generation cephalosporins, carbapenems, or quinolones anything BUT ampicillin or ticarcillin. Note the BUT. BUT BUT BUT.

For diarrhea ciprofloxacin, 750 mg once a day; or azithromycin, 500 mg once a day, both for 3 days (PubMed).

Notes

I once had a patient who had a severe colitis from Aeromonas and the source was Holy Water she brought back from a Catholic shrine in S. America. True story. From this I deduce that Louis Pasture went to Hell.

It is possible  to get a variety of infections from Holy Water.