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Indian Pediatr 2013;50: 969-970 |
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Cholera-like Illness Due to Aeromonas
caviae
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K Jagadish Kumar and *G S Vijaya Kumar
Departments of Pediatrics and *Microbiology, JSS
Medical College and Hospital, Mysore, Karnataka, India.
Email: [email protected]
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A 2-year-old girl presented with rice watery stools and
vomiting for 12 hours. There was no blood in the stools. On
examination she had some dehydration. Stool microscopy and
hanging drop revealed darting motile bacilli morphologically
resembling Vibrio cholera. Her blood count and renal
function tests were normal. Dehydration was corrected with
IV Ringer lactate and she was commenced on Azithromicin. Her
HIV status was non-reactive. Stool culture grew Aeromonas
caviae, which was sensitive to doxycycline,
chloramphenicol, furazolidine and resistant to nalidixic
acid, ceftraixone, co-trimaxazole and ampicillin. She was
discharged after three days.
Aeromonas species are ubiquitous
water borne medically important, Gram-negative, rod-shaped
micro-organisms [1]. Today, they are regarded not only as
disease-causing pathogen of fish but are also responsible
for variety of complications in both immunocompetent and
immunocompromised humans [2]. Aeromonas have gained
importance as human pathogens causing gastrointestinal
infections. They also cause extraintestinal infections such
as cellulitis, wound infections, sepsis and urinary tract
infections [1]. Deodhar, et al. [3] isolated
Aeromonas from 45 (1.8%) of 2,480 patients with acute
gastroenteritis. Out of 863 traveller’s diarrhea patients
returning from Asia, Africa, and Latin America, 2% of cases
were caused by Aeromonas [4]. Studies have shown that
three Aeromonas (A. hydrophila, A. caviae and A.
veronii bv Sobria) are responsible for
≥85% of
human infections [2]. Clinical spectrum of Aeromonas-induced
diarrhoea varies from toxigenic diarrhea to colitis and in
developing countries it is predominantly toxigenic [3]. The
most common presentation for Aeromonas gastroenteritis is
secretory(watery) enteritis suggesting the toxigenic nature
of the organism [2]. Aeromonas strains are almost
universally susceptible to fluoroquinolones and exhibited
multidrug resistance [2]. Bhowmika, et al. [1]
isolated potentially pathogenic and multi-drug-resistant
strains of A. hydrophila from natural surface
waters, and showed its ability to produce
virulence-associated factors similar to that in clinical
isolates thereby indicating a significant risk to public
health [1]. To conclude, Aeromonas associated
gastroenteritis in children mimics cholera and the presence
of this emerging organism should be kept in mind while
treating acute gastroenteritis.
References
1. Bhowmik P, Bag PK, Hajra TK, Rituparna
De, Sarkar P, Ramamurthy T. Pathogenic potential of Aeromonas
hydrophila isolated from surface waters in Kolkata,
India. J Med Microbiol.2009; 58:1549-58.
2. Janda JM, Abbott SL. The genus Aeromonas:
Taxonomy, pathogenicity, and infection. Clin Microbiol
Rev. 2010;23:35-73.
3. Deodhar LP, Saraswathi K, Varudkar A.
Aeromonas spp. and their association with human
diarrheal disease. J Clinical Microbiol.1991;29:853-6.
4. Vila J, Ruiz J, Gallardo F,Vargas M, Soler
L,Figueras MJ, et al. Aeromonas spp. and
traveler’s diarrhea: clinical features and antimicrobial
resistance. Emerg Infect Dis. 2003;9:552-5.
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