Cargando…
Lethal Aeromonas veronii Sepsis in the Course of Medicinal Leech Therapy
A patient with oral squamous cell carcinoma (OSCC) underwent complex surgical tumor therapy, including the reconstruction of soft tissues using a radial forearm flap. Due to venous congestion that could only partly be resolved by revision surgery, leech therapy was started on the second postoperativ...
Autores principales: | , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9495195/ https://www.ncbi.nlm.nih.gov/pubmed/36139958 http://dx.doi.org/10.3390/antibiotics11091180 |
_version_ | 1784793965415890944 |
---|---|
author | Sproll, Christoph Lommen, Julian Balasiu, Adriana Schorn, Lara Kübler, Norbert R. Henrich, Birgit Kram, Rainer Petersdorf, Sabine |
author_facet | Sproll, Christoph Lommen, Julian Balasiu, Adriana Schorn, Lara Kübler, Norbert R. Henrich, Birgit Kram, Rainer Petersdorf, Sabine |
author_sort | Sproll, Christoph |
collection | PubMed |
description | A patient with oral squamous cell carcinoma (OSCC) underwent complex surgical tumor therapy, including the reconstruction of soft tissues using a radial forearm flap. Due to venous congestion that could only partly be resolved by revision surgery, leech therapy was started on the second postoperative day. The patient developed pneumonia and sepsis and died as a result of septic shock, despite having received targeted broad-spectrum antibiotic therapy since day 5. Aeromonas spp. were cultured from both the patient’s specimens and unused leeches. Biochemical identification and matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) yielded inconsistent identification results. Finally, microbiological identification of Aeromonas spp. was performed via 16S rDNA sequencing and use of the basic local alignment search tool (BLAST), and strains from both the patient and the leeches were identified as Aeromonas veronii. Aeromonas spp. strains derived from the patient and leeches and independent laboratory strains were submitted to randomly amplified polymorphic DNA (RAPD) subtyping. RAPD of A. veronii strains from both sources revealed an identical pattern, strongly suggesting the transmission of A. veronii from the leeches to the patient. Physicians should be aware of the potential for severe lethal infections as a fatal side-effect of leech therapy in critically ill patients, which should be addressed using antibiotic prophylaxis. |
format | Online Article Text |
id | pubmed-9495195 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-94951952022-09-23 Lethal Aeromonas veronii Sepsis in the Course of Medicinal Leech Therapy Sproll, Christoph Lommen, Julian Balasiu, Adriana Schorn, Lara Kübler, Norbert R. Henrich, Birgit Kram, Rainer Petersdorf, Sabine Antibiotics (Basel) Case Report A patient with oral squamous cell carcinoma (OSCC) underwent complex surgical tumor therapy, including the reconstruction of soft tissues using a radial forearm flap. Due to venous congestion that could only partly be resolved by revision surgery, leech therapy was started on the second postoperative day. The patient developed pneumonia and sepsis and died as a result of septic shock, despite having received targeted broad-spectrum antibiotic therapy since day 5. Aeromonas spp. were cultured from both the patient’s specimens and unused leeches. Biochemical identification and matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) yielded inconsistent identification results. Finally, microbiological identification of Aeromonas spp. was performed via 16S rDNA sequencing and use of the basic local alignment search tool (BLAST), and strains from both the patient and the leeches were identified as Aeromonas veronii. Aeromonas spp. strains derived from the patient and leeches and independent laboratory strains were submitted to randomly amplified polymorphic DNA (RAPD) subtyping. RAPD of A. veronii strains from both sources revealed an identical pattern, strongly suggesting the transmission of A. veronii from the leeches to the patient. Physicians should be aware of the potential for severe lethal infections as a fatal side-effect of leech therapy in critically ill patients, which should be addressed using antibiotic prophylaxis. MDPI 2022-08-31 /pmc/articles/PMC9495195/ /pubmed/36139958 http://dx.doi.org/10.3390/antibiotics11091180 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Case Report Sproll, Christoph Lommen, Julian Balasiu, Adriana Schorn, Lara Kübler, Norbert R. Henrich, Birgit Kram, Rainer Petersdorf, Sabine Lethal Aeromonas veronii Sepsis in the Course of Medicinal Leech Therapy |
title | Lethal Aeromonas veronii Sepsis in the Course of Medicinal Leech Therapy |
title_full | Lethal Aeromonas veronii Sepsis in the Course of Medicinal Leech Therapy |
title_fullStr | Lethal Aeromonas veronii Sepsis in the Course of Medicinal Leech Therapy |
title_full_unstemmed | Lethal Aeromonas veronii Sepsis in the Course of Medicinal Leech Therapy |
title_short | Lethal Aeromonas veronii Sepsis in the Course of Medicinal Leech Therapy |
title_sort | lethal aeromonas veronii sepsis in the course of medicinal leech therapy |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9495195/ https://www.ncbi.nlm.nih.gov/pubmed/36139958 http://dx.doi.org/10.3390/antibiotics11091180 |
work_keys_str_mv | AT sprollchristoph lethalaeromonasveroniisepsisinthecourseofmedicinalleechtherapy AT lommenjulian lethalaeromonasveroniisepsisinthecourseofmedicinalleechtherapy AT balasiuadriana lethalaeromonasveroniisepsisinthecourseofmedicinalleechtherapy AT schornlara lethalaeromonasveroniisepsisinthecourseofmedicinalleechtherapy AT kublernorbertr lethalaeromonasveroniisepsisinthecourseofmedicinalleechtherapy AT henrichbirgit lethalaeromonasveroniisepsisinthecourseofmedicinalleechtherapy AT kramrainer lethalaeromonasveroniisepsisinthecourseofmedicinalleechtherapy AT petersdorfsabine lethalaeromonasveroniisepsisinthecourseofmedicinalleechtherapy |