A Fatal Case of Aeromonas hydrophila Septicemia with Symptoms Similar to Deep Vein Thrombosis of the Arm at the Onset

Abstract

We report a case of Aeromonas hydrohila septicemia in a previously healthy and non-immunocompromised patient without any trauma. The onset was sudden with symptoms resembling acute deep vein thrombosis. Shortly, the patient suffered progressive myonecrosis and gas gangrene with rapid fatal outcome. A 55-year-old man noticed left elbow pain 12 hours prior to admission. The left upper extremity was diffusely swollen with several hemorrhagic bullae on the dorsum of the hand and forearm. Angiographic findings revealed no obstructive changes in the vein. Despite the intensive therapy, his general condition progressively worsened, and gas production with a foul odor began. With the diagnosis of gas gangrene, disarticulation of the left upper extremity was performed. Postoperatively, the patient became hypotensive without response to intravenous fluid and cathecholamines and he died 24 hours after admission. Aeromonas hydrophila was identified from samples of arm muscle and blood obtained at the operation.