Case report: Edwardsiella tarda Sepsisfollowing Abortion.

Abstract

Edwardsiella tarda is a Gram negative bacterium of Family Enterobacteriaceae - primarily a pathogen of fish. Human infections with E. tarda are rare. Reports of E. tarda septicemia is exceptional (<5%) with mortality of 44.6%. We report a case of E. tarda sepsis following an abortion. Case report A 31 year old female patient (P3C2) with period of amenorrhea of 12 weeks and 2 days was admitted with a history of lower abdominal pain and vaginal bleeding for 1 day with a similar episode 1 week prior. Patient was febrile with 1010F on admission. Her past medical history was uneventful except gestational diabetes. Hematological investigations on admission revealed WBC–17.5X103/UL with 80.0% granulocytes and CRP-52 mg/L. Abdominal ultrasound scanning found aborting fetus. Patient was started with empirical antibiotics as intravenous cefuroxime, metronidazole and gentamicin. Blood culture developed turbidity, 24 hours after incubation and grew Gram negative, motile bacillus on blood, chocolate and MacConkey agar as non-lactose fermenter. Moderate amount of H2S production was in Kligler Iron Agar (KIA)with acid butt and alkaline slant. Isolate was urease negative and indole positive. It was identified as E. tarda and was sensitive to most of the antibiotics: amikacin, cefotaxime, ceftazidime, cefuroxime, ciprofloxacin, co–amoxiclav, gentamicin and netilmicin but was resistant to polymyxin as per Stokes‘ comparative disc diffusion method. Evacuation of Retained Products of Conception was done 2 days following admission. Following antibiotics, patient was afebrile and improved clinically. Parenteral antibiotics were continued for one week, patient had uneventful recovery and was discharged with one week of oral antibiotics.