Gastric submucosal abscess caused by Edwardsiella tarda infection: a case report
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CASE REPORT
Open Access
Gastric submucosal abscess caused by Edwardsiella tarda infection: a case report Koshi Ota1* , Hiroki Yamanoue2, Nobuyuki Aizawa2, Naoyuki Suzuki2, Kanna Ota1 and Akira Takasu1
Abstract Background: Edwardsiella tarda is a motile, facultatively anaerobic gram-negative bacillus that is isolated from a wide spectrum of animals in aquatic environments but rarely causes infection in humans. Here, we describe the case of a gastric submucosal abscess caused by E. tarda infection. Case presentation: The patient was a 74-year-old man with a history of hypertension and chronic alcohol consumption who was admitted to our hospital for abdominal pain, appetite loss and vomiting. Contrast-enhanced computed tomography (CT) revealed choledocholithiasis in the common bile duct, a gastric wall abscess and an intra-abdominal abscess. Endoscopic ultrasound (EUS)-guided drainage with antibiotics successfully cured the patient. Conclusion: The combination of CT, endoscopy and EUS-guided drainage with antibiotic therapy might be effective for diagnosis and treatment of a gastric submucosal abscess caused by E. tarda infection. Keywords: Edwardsiella tarda, Endoscopic ultrasound (EUS)-guided drainage, Gastric submucosal abscess, Intraabdominal abscess
Background Edwardsiella tarda is a motile, facultatively anaerobic gram-negative bacillus that is commonly found in aquatic environments [1]. E. tarda is an important pathogen of fish living in both freshwater and saltwater. In human, gastroenteritis is observed in 80% of all E. tarda foodborne infections [2, 3]. The remaining 20% of human E. tarda infections are extraintestinal diseases including myonecrosis, soft tissue infections, meningitis, peritonitis with sepsis, bacteremia and wound infections [1, 4]. A gastric submucosal abscess is primarily caused by bacterial infection of the gastric wall and often has a poor prognosis [5]. This type of abscess is rare because of the rich blood supply to the gastric wall and the bactericidal action of gastric acid [6]. Treatment strategies have
* Correspondence: [email protected] 1 Department of Emergency Medicine, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki City, Osaka 596-8686, Japan Full list of author information is available at the end of the article
included endoscopic drainage and systemic antibiotics with or without surgical resection of the abscess [7]. Here, we describe a rare case in which a patient developed a gastric submucosal abscess caused by E. tarda infection. Endoscopic ultrasound (EUS)-guided drainage with antibiotic therapy successfully cured the patient. We obtained verbal and written informed consent from the patient for reporting this case.
Case presentation A 74-year-old man was admitted to our hospital with a 4-day history of abdominal pain, appetite loss and vomiting. He took 40 mg telmisartan, 5 mg amlodipine besilate combined drug and 2.5 mg amlodipine besilate for hypertension with 100 mg celecoxib, 37.5 mg tramadol hydrochloride/325 mg acetaminophen and 0.5 mg etizolam. He
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