Lab Med Online.  2013 Jul;3(3):174-177. 10.3343/lmo.2013.3.3.174.

Liver Abscess Caused by Edwardsiella tarda: A Case Report

• Choi W
• Shin SH
• Park KG
• Kim Y
• Bae SH
• Park YJ

• KMID: 2053553
• DOI: http://doi.org/10.3343/lmo.2013.3.3.174

Abstract

Edwardsiella tarda is a member of the family Enterobacteriaceae, commonly found in tropical and subtropical aquatic environments. Most E. tarda infections are linked to exposure to water or animals that inhabit water. However, it is still an uncommon pathogen in humans and causes mainly watery diarrhea. We describe a case of liver abscess caused by E. tarda. A 60-yr-old Korean man, with underlying diabetes mellitus, had a 10-day stay in Egypt 15 days before presentation. Ultrasound-guided percutaneous transhepatic abscess aspiration was performed. Pus culture revealed E. tarda, which was susceptible to all the antibiotics commonly used against Gram-negative organisms. The patient was treated with cefobactam for 10 days and piperacillin/tazobactam for another 5 days combined with an additional abscess aspiration due to recurrent fever. This therapy led to clinical improvement. The possible source of infection in this case may have been the drinking water supplied during travel in Egypt, but we cannot completely rule out a domestic source, because a liver abscess caused by E. tarda has been reported in a Japanese patient without travel history. Considering the Korean custom of eating raw fish or shrimp, climate changes, and increasing international travel, infections due to E. tarda may increase in Korea. Clinical microbiologists should be aware of this potential pathogen, and prompt investigation of the infection source and site is needed.

Keyword

Edwardsiella tarda; Liver abscess; Travel

MeSH Terms

Abscess
Animals
Anti-Bacterial Agents
Asian Continental Ancestry Group
Climate Change
Diabetes Mellitus
Diarrhea
Drinking Water
Eating
Edwardsiella
Edwardsiella tarda
Egypt
Enterobacteriaceae
Fever
Humans
Korea
Liver
Liver Abscess
Suppuration
Water
Anti-Bacterial Agents
Drinking Water
Water

Figure

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  Fig. 1 Initial abdominal enhanced CT findings on the first diagnosis of liver abscess. A multilobulated hypodense lesion (3 cm × 3 cm) in the 6th segment of liver is indicated by an arrow.

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  Fig. 2 Abdominal enhanced CT findings at 2 weeks after discharge. The multilobulated cystic lesion has regressed, with focal inflammatory changes indicated by an arrow.

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