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| Year : 2014 | Volume
: 57
| Issue : 3 | Page : 521-522 |
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| Aeromonas species isolated from a case of meningitis |
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Muddaiah Ravish Kumar, Vadnal Nagendrappa Venkatesh, Karanam Subramanyam Sudhindra
Department of Microbiology, Basaveshwara Medical College, Chitradurga, Karnataka, India
Click here for correspondence address and email
| Date of Web Publication | 14-Aug-2014 |
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How to cite this article:
Kumar MR, Venkatesh VN, Sudhindra KS. Aeromonas species isolated from a case of meningitis. Indian J Pathol Microbiol 2014;57:521-2 |
Editor,
Aeromonas species are Gram-negative, motile, facultative anaerobic, rod shaped, and oxidase positive bacteria of the recently assigned family Aeromonadaceae.[1] Aeromonas species are ubiquitous water borne organisms and in recent years have gained importance as human pathogens causing gastrointestinal infections and extra intestinal infections such as cellulitis, wound infection, peritonitis, endocarditis, osteomyelitis, meningitis and suppurative arthritis in patients with leukemia. [2] Meningitis caused by this organism is a rare clinical entity. Aeromonas meningitis may involve all age groups and can be either community or nosocomially acquired. [3]
A 4-month-old male child presented with history of fever and vomiting for 2 days and seizures for 1-day. There was uprolling of eyes with frothing from mouth and flexion of both upper and lower limbs present. Hematological investigation showed hemoglobin 10 g% and total white blood cell (WBC) count of 19,700 cells/cumm.
Cerebrospinal fluid (CSF) analysis showed concentration of glucose and protein as 25 mg/dL and 115 mg/dL respectively. Cytological analysis showed a WBC count of 500 cells/cumm (N-80% and L-20%).
The CSF specimen was centrifuged and from the sediment Grams stain and culture was done. Gram stain showed plenty of pus cells with Gram-negative Bacilli. Culture on blood agar showed hemolytic colonies and on MacCokey agar HiMedia Laboratories Pvt. Ltd. A-516, Swastik Disha Business Park,Via Vadhani Ind. Est., LBS Marg, Mumbai-400086, India. nonlactose fermenting colonies were seen. The organism was oxidase and catalase positive, indole was produced, Voges prausker test was positive, esculin and arginine dihydrolysed. The isolate was identified as Aeromonas hydrophila. It was also confirmed by running in Vitek-2 systems version: 05.04 Biomerieux, Unit No-104, Prestige Center Point, Cunningham Rd, Vasanth Nagar, Bangalore, Karnataka 560052. The same organism was isolated from the repeat sample.
The antimicrobial sensitivity pattern showed that the organism was sensitive to amikacin, imipenam, meropenam and resistant to cefotaxime, ciprofloxacin, gentamycin, amoxycillin, pipericillin-tazobactum, cefaperazone-sulbactum, netilmycin.
Based on results of the antimicrobial sensitivity, patient was started on injection meropenam intravenously for 7 days and the baby recovered.
Aeromonas species are Gram-negative, nonsporulating facultative anaerobic rods that are usually beta hemolytic on blood agar and ferment carbohydrates with acid and gas production. They are oxidase positive and this test distinguishes these organisms from the oxidase-negative Enterobacteriaceae. [4] Most of the studies on Aeromonas are associated with acute gastroenteritis. [1],[2],[5] Aeromonas meningitis is a rare clinical entity and we isolated A. hydrophila from a 4-month-old child CSF and as well as from blood samples, with a history unhygienic bottle feeding. The patient was treated with injection C-tri 250 mg BD, injection gardinal 3 units BD before sending for investigation. Based on antimicrobial susceptibility pattern, the child was started on injection amikacin 750 mg intravenous (IV) OD with dilution and injection maczone 260 mg IV 12 hourly. The child recovered and discharged after 7 days.
 Acknowledgement | |  |
Dr. Sanjay,Consultant Pathologist, Adithya diagnostics, Sriseetha, RMR road, Park extension, Shimoga-577201
| References | | |
| 1. | Kannan S, Chattopadhyay UK, Pal D, Shimada T, Takeda Y, Bhattacharya SK, et al. Isolation and identification of Aeromonas from patients with acute diarrhoea in Kolkata, India. Indian J Med Microbiol 2001;19:190-2.  [ PUBMED]  |
| 2. | Vasaikar S, Saraswathi K, De A, Varaiya A, Gogate A. Aeromonas species isolated from cases of acute gastroenteritis. Indian J Med Microbiol 2002;20:107-9. [ PUBMED] |
| 3. | Seetha KS, Jose BT, Jasthi A. Meningitis due to Aeromonas hydrophila. Indian J Med Microbiol 2004;22:191-2. [ PUBMED] |
| 4. | Gunasekaran L, Ambalkar S, Samarji RA, Qamruddin A. Post-traumatic osteomyelitis due to Aeromonas species. Indian J Med Microbiol 2009;27:163-5. [ PUBMED] |
| 5. | Alavandi SV, Ananthan S. Biochemical characteristics, serogroups, and virulence factors of Aeromonas species isolated from cases of diarrhoea and domestic water samples in Chennai. Indian J Med Microbiol 2003;21:233-8. [ PUBMED] |
Correspondence Address:
Muddaiah Ravish Kumar
Department of Microbiology, Basaveshwara Medical College, Chitradurga - 577 501, Karnataka
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/0377-4929.138820
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