A Fatal Case of Aeromonas Hydrophila Septicemia after Surgery for Malignant Lymphoma of Stomach

Kenji Hasegawa, Tsunehide Osawa, Naoko Kamano, Yoshiro Masuya, Masashi Okuno, Osamu Yamada, Hideho Takada, Hideo Nakaya¹⁾ and Katsuhiko Miyoshi²⁾

Department of Surgery, Division of Biological examination¹⁾, Kouri Hospital of Kansai Medical University Seijyukai Hospital²⁾

Necrotic fascitis by Aeromonas hydrophila is quite rare. We report a severe case of this complication after surgery for gastric malignancy. A 74-year-old woman with malignant lymphoma of the whole stomach underwent total gastrectomy. Postoperatively, she showed septic symptoms by the evening of the day of operation. By the next day, subcutaneous hemorrhage had appeared in her abdominal wall, and necrotic fascitis developed several hours afterward. Necrotic skin and subcutaneous tissues were aggressively excised and antibiotic therapy changed to cover all suspected bacteria. Gram-negative bacillus was noted in smear Gram staining incised necrotic tissue, ascites, and blood. The patient died about 50 hours after operation, despite attempts at resuscitation. The colonization of Aeromonas hydrophila was obtained some days later. To our knowledge, this is the first case reported of postoperative necrotic fascitis and sepsis by Aeromonas hydrophila. We suggest that since infection by Aeromonas hydrophila can be very serious for the compromised host, prophylactic antibiotics covering Gramnegative bacillus should be used for such patients.

Key words
Aeromonas hydrophila, necrotizing fascitis, septic shock

Reprint requests
Kenji Hasegawa Department of Surgery, Kouri Hospital of Kansai Medical University 8-45 Kourihondouri-cho, Neyagawa-city, 572-8551 JAPAN

Accepted
September 19, 2001

To read the PDF file you will need Abobe Reader installed on your computer.