A Severe Case of Aeromonas Hydrophila Infection after Surgery for Gastric Cancer

A 72-year-old woman undergoing total gastrectomy for gastric cancer became acutely ill with septic shock and adult respiratory distress syndrome, on post operative day (POD) 1, but the focus of infection was not detected. She developed abdominal distension, diarrhea, necrotic change in the abdominal skin, and subcutaneous emphysema in the chest wall. She died on POD 3 despite intensive care. Aeromonas hydrophila was cultured from the specimen on POD 2. An inspection of the hospital environment found no strain matching the patient's, so the origin of Aeromonas hydrophila remains unknown. Aeromonas sometimes causes food poisoning, and 31 reports during the past 15 years in Japan state that Aeromonas infection is highly progressive and fatal, as our case. Postoperative Aeromonas infection is rare but very serious, and requires particularly vigilant monitoring.