Fatal Edwardsiella tarda Sepsis in a Patient with End-stage Multiple Myeloma: A Case of Suspected Zoonotic Transmission.
Yuka Tanaka, Keita Sugihara, Ryota Minami et al.
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Case in brief
A 74-year-old man with refractory end-stage multiple myeloma and profound treatment-related immunodeficiency developed septic shock after acquiring tropical fish. Blood cultures grew Edwardsiella tarda, an aquatic pathogen; the isolate was susceptible to the broad-spectrum antibiotics administered, including meropenem. He nevertheless died within 72 hours of admission.
What made this case unusual
The suspected link between tropical fish exposure and E. tarda sepsis occurred in a patient with cumulative immunosuppression from multiple classes of anti-myeloma therapy; death followed despite in-vitro antibiotic susceptibility.
Diagnostic / clinical pearl
In severe E. tarda infection in an immunocompromised patient, ask about aquatic and other environmental exposures; antibiotic susceptibility does not ensure a favorable outcome.
Why it matters
The report highlights environmental history-taking and counseling about exotic pet ownership as considerations for profoundly immunocompromised patients.