Aeromonas hydrophila ecthyma gangrenosum without bacteraemia in a diabetic man: the first case report in Italy Echtyma gangrenosum da Aeromonas hydrophila in uomo diabetico in assenza di batteriemia: il primo caso segnalato in Italia

A eromonas hydrophila is a motile Gram-negative rod-shaped bacterium found in water sources that is typically pathogenic for fish. Although human beings are atypical hosts, A. hydrophila has been reported to cause a broad spectrum of disease syndromes (acute gastroenteritis, soft tissue infections, meningitis, peritonitis, sepsis) [1]. While initially believed to be an opportunistic organism only capable of infecting immunocompromised individuals, a body of evidence now indicates that A. hydrophila causes a range of extraintestinal illness in immunocompetent hosts [2-7]. In the literature A. hydrophila wound infections reports are increasing and are represented by three types in order of increasing severity: cellulitis, myonecrosis and ecthyma gangrenosum [8-10]. Ecthyma gangrenosum is a cutaneous necrotic or gangrenous pustule that occurs secondary to sepsis known to be caused by Pseudomonas aeruginosa sepsis usually in immunocompromised people [11, 12]. Lesions have an erythematous border surrounding a vesicle which can progress to necrosis of the soft tissue within 24 hours. This type of infection is usually fatal [13]. Early diagnosis and suitable antibiotic therapy are important for the management of ecthyma gangrenosum. In this report we present a case of A. hydrophila ecthyma gangrenosum without bactaeremia in a diabetic male.