Sepsis caused by Aeromonas in the course of bronchial asthma treated with corticosteroids
Jelić, S.; Milutinović, M.; Rosić, D.
Srpski Arhiv Za Celokupno Lekarstvo 106(4): 445-451
1978
ISSN/ISBN: 0370-8179 PMID: 220739 Document Number: 4586
According to data from medical literature, up to 1975 fifty cases of septicaemia caused by Aeromonas species have been reported, mainly in patients with compromised defence mechanisms (chiefly Laennec's cirrhosis and acute leukemia). The portal of entry into the bloodstream seemed nearly a.11ways to be the digestive system, more rarely skin wounds infected by polluted waters. To this series of cases we add one more in which Aeromonas hydrophylla septicaemia occured during a high dose corticosteroid treatment for severe bronhial asthma in a male patient aged 60. In this patient the high dose corticosteroid treatment was instituted because of the severity of the asthmatic attack. Aeromonas, first recovered from the throat swab, was found to invade during this treatment the lower respiratory tract. Subsequently it invaded the bloodstream and was recovered from two blood cultures. The bloodstream invasion was floowed by a fullblown septicaemic picture, not different fu septicaemic states caused by other gram negative bacilli. However, the occurenoe of a transitory Coombspositive auto-immune haemolytic anaemia is to be noted. Gentamycin treatment was not effective, but carbenicilline administration resulted in a complete clinical recovery. In our case, Aeromonas was not cultivated from faeces and there is no evidence that digestive system represented the portal of entry of Aeromonas in the bloodstream. Aeromonas seems to have invaded the bloodstream via the respiratory tract, the exact mechanism remaining unknown. It is not clear how the micro-organism has reached the upper airways of our patient, as it has been established that the natural habitat of Aeromonads which are potentially pathogenic for humans, are waters with a high content of 'organic substances of nonfaeoal origin.
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