10 April 2024
: Case report 
A Rare Cause of Empyema and Bacteremia Due to Shewanella Species in Alcoholic Cirrhosis Patients: A Case Report and Comprehensive Review of Literature
Unusual clinical course
Bohui Qian1BCDEF, Kazuhiro Ishikawa1ABDEF*, Tomoaki Nakamura2CDEF, Katsuhito Kinoshita2CDEF, Tetsuhiro Masaki1CF, Takahiro Matsuo1ADE, Fujimi Kawai
3ABF, Nobuyoshi Mori 1DE
DOI: 10.12659/AJCR.941952
Am J Case Rep 2024; 25:e941952
Table 2. Baseline characteristics of patients, management of infection, and prognosis.
| Total (N=124) | Shewanella algae (n=39) | Shewanella haliotis (n=7) | Shewanella putrefaciens (n=77) | Shewanella xiamenensis (n=1) | |||
|---|---|---|---|---|---|---|---|
| Age (median) [range] | 61.6 [56.0–75.0] | 62.9 [58.0–75.0] | 77.6 [72.0–82.0] | 58.6 [50.0–73.0] | 74.0 | ||
| Male | 75/93 (81%) | 34 (87%) | 7 | (100%) | 34/46 (74%) | 0 (0%) | |
| Female | 18/93 (19%) | 5 (13%) | 0 | (0%) | 12/46 (26%) | 1 (100%) | |
| Hepatobiliary | 38/114 (33%) | 14/38 (37%) | 6 | (86%) | 17/68 (25%) | 1 (100%) | |
| Malignancy | 28/114 (25%) | 11/38 (29%) | 5 | (71%) | 12/68 (18%) | 0 (0%) | |
| Cardiology | 27/114 (24%) | 11/38 (29%) | 1 | (14%) | 15/68 (22%) | 0 (0%) | |
| Dermatology | 26/114 (23%) | 11/38 (29%) | 0 | (0%) | 15/68 (22%) | 0 (0%) | |
| Diabetes | 21/114 (18%) | 7/38 (18%) | 1 | (14%) | 12/68 (18%) | 1 (100%) | |
| Renal | 20/114 (18%) | 9/38 (24%) | 1 | (14%) | 10/68 (15%) | 0 (0%) | |
| Pulmonary | 19/114 (17%) | 3/38 (8%) | 0 | (0%) | 16/68 (24%) | 0 (0%) | |
| GI | 12/114 (11%) | 3/38 (8%) | 1 | (14%) | 8/68 (12%) | 0 (0%) | |
| Endocrinology | 10/114 (9%) | 2/38 (5%) | 0 | (0%) | 8/68 (12%) | 0 (0%) | |
| Dialysis | 8/114 (7%) | 2/38 (5%) | 1 | (14%) | 5/68 (7%) | 0 (0%) | |
| Neurology | 5/114 (4%) | 0 (0%) | 0 | (0%) | 5/68 (7%) | 0 (0%) | |
| Urology | 4/114 (4%) | 2/38 (5%) | 0 | (0%) | 2/68 (3%) | 0 (0%) | |
| Device | 3/114 (3%) | 1/38 (3%) | 0 | (0%) | 2/68 (3%) | 0 (0%) | |
| Gynecology | 2/114 (2%) | 0 (0%) | 0 | (0%) | 2/68 (3%) | 0 (0%) | |
| SSTI | 43/123 (35%) | 21 (54%) | 2 | (29%) | 20/76 (26%) | 0 (0%) | |
| Respiratory | 22/123 (18%) | 0 (0%) | 0 | (0%) | 22/76 (29%) | 0 (0%) | |
| Hepatobiliary | 13/123 (11%) | 6 (15%) | 5 | (71%) | 2/76 (3%) | 0 (0%) | |
| GI | 4/123 (3%) | 3 (8%) | 0 | (0%) | 1/76 (1%) | 0 (0%) | |
| Empyema | 3/123 (2%) | 2 (5%) | 0 | (0%) | 1/76 (1%) | 0 (0%) | |
| Others | 10/123 (81%) | 6 (15%) | 0 | (0%) | 4/76 (5%) | 0 (0%) | |
| Skin lesion | 21/35 (60%) | 11/20 (55%) | 2/2 | (100%) | 8/13 (62%) | 0/0 (0%) | |
| Oral | 9/35 (26%) | 7/20 (35%) | 0/2 | (0%) | 2/13 (15%) | 0/0 (0%) | |
| Intravascular catheter | 2/35 (6%) | 0/20 (0%) | 0/2 | (0%) | 2/13 (15%) | 0/0 (0%) | |
| Respiratory tract | 2/35 (6%) | 1/20 (5%) | 0/2 | (0%) | 1/13 (8%) | 0/0 (0%) | |
| Others | 3/35 (9%) | 3/20 (15%) | 0/2 | (0%) | 0 (0%) | 0/0 (0%) | |
| API 20 NE system | 41/93 (44%) | 4/28 (14%) | 0 (0%) | 37/57 | (65%) | 0 (0%) | |
| 16S rRNA gene sequence analysis | 24/93 (26%) | 15/28 (54%) | 7 (100%) | 1/57 (2%) | 1 (100%) | ||
| VITEK 2 GN | 10/93 (11%) | 3/28 (11%) | 0 (0%) | 7/57 (12%) | 0 (0%) | ||
| ID 32 GN | 10/93 (11%) | 1/28 (4%) | 0 (0%) | 9/57 (16%) | 0 (0%) | ||
| MALDI-TOF-MS | 8/93 (9%) | 4/28 (14%) | 0 (0%) | 4/57 (7%) | 0 (0%) | ||
| Conventional method | 5/93 (5%) | 4/28 (14%) | 0 (0%) | 1/57 (2%) | 0 (0%) | ||
| Others | 2/93 (2%) | 1/28 (4%) | 0 (0%) | 1/57 (2%) | 0 (0%) | ||
| Antibiotics | 89/89 (100%) | 39 (100%) | 7 (100%) | 42/42 | (100%) | 1 (100%) | |
| Drainage | 14/89 (16%) | 10 (26%) | 0 (0%) | 4/42 (10%) | 0 (0%) | ||
| Debridement | 14/89 (16%) | 9 (23%) | 0 (0%) | 5/42 (12%) | 0 (0%) | ||
| Others | 1/89 (1%) | 0 (0%) | 0 (0%) | 1/42 (2%) | 0 (0%) | ||
| Third or Fourth generation cephalosporin | 39/87 (45%) | 24 (62%) | 3 (43%) | 12/40 | (30%) | 0 (0%) | |
| Penicillin | 35/87 (40%) | 17 (44%) | 1 (14%) | 17/40 | (43%) | 0 (0%) | |
| Aminoglycoside | 31/87 (36%) | 7 (18%) | 1 (14%) | 23/40 | (58%) | 0 (0%) | |
| Antibiotics alone | 47/63 (74%) | 16/21 (76%) | 6 (86%) | 24/34 | (71%) | 1 (100%) | |
| Antibiotics+drainage | 9/11 (82%) | 7/8 (88%) | None | 2/3 (67%) | None | ||
| Antibiotics+debridement | 9/10 (90%) | 7/7 (100%) | None | 2/3 (67%) | None | ||
| Antibiotics+drainage+debride ment | 2/3 (67%) | 1/2 (50%) | None | 1/1 (100%) | None | ||
| SSTI – skin and soft tissue infections; GI – gastrointestinal diseases; MALDI-TOF-MS – matrix-assisted laser desorption ionization-time of flight mass spectrometry; rRNA – ribosomal ribonucleic acid. | |||||||