Introduction:

Aeromonas species are Gram-negative bacteria commonly found in aquatic environments, capable of causing a range of infections in humans. Clinical manifestations of Aeromonas spp. infections vary depending on the route of transmission, underlying host factors, and bacterial virulence. This article explores the diverse clinical features of Aeromonas spp. infections, aiding in their recognition and management.

Gastrointestinal Infections:

• Acute Gastroenteritis: The most common clinical presentation of Aeromonas spp. infections is acute gastroenteritis, characterized by symptoms such as diarrhea, abdominal pain, nausea, vomiting, and fever. Diarrhea may be watery or bloody, resembling other bacterial enteric pathogens.
• Chronic Diarrhea: In some cases, Aeromonas spp. infections can lead to chronic or persistent diarrhea, particularly in immunocompromised individuals or those with underlying gastrointestinal disorders. Chronic symptoms may be accompanied by malabsorption and weight loss.

Skin and Soft Tissue Infections:

• Cellulitis: Aeromonas spp. can cause localized cellulitis following traumatic injuries or exposure to contaminated water. Clinical features include erythema, swelling, warmth, and tenderness at the site of infection. Cellulitis may progress to develop purulent discharge and systemic symptoms in severe cases.
• Wound Infections: Aeromonas spp. can colonize traumatic wounds or surgical incisions, leading to wound infections characterized by delayed healing, erythema, purulent discharge, and localized pain. In severe cases, wound infections may progress to necrotizing fasciitis or systemic infection.

Systemic Infections:

• Bacteremia and Septicemia: Aeromonas spp. bacteremia can occur secondary to gastrointestinal translocation, skin and soft tissue infections, or invasive procedures. Systemic symptoms may include fever, chills, hypotension, and organ dysfunction, posing a risk of septic shock if untreated.
• Peritonitis: In patients undergoing peritoneal dialysis or abdominal surgery, Aeromonas spp. peritonitis can occur due to contamination of dialysis fluid or intra-abdominal surgical sites. Clinical features include abdominal pain, cloudy dialysate, and systemic signs of infection.

Respiratory Infections:

• Pneumonia: Although less common, Aeromonas spp. can cause community-acquired or healthcare-associated pneumonia, particularly in individuals with underlying lung disease or immunosuppression. Clinical features include cough, dyspnea, chest pain, and fever, with radiographic evidence of pulmonary infiltrates.

Extraintestinal Infections:

• Urinary Tract Infections: Aeromonas spp. can colonize the urinary tract, leading to urinary tract infections (UTIs) characterized by dysuria, frequency, urgency, and suprapubic discomfort. Pyelonephritis and bacteremia may occur in severe cases.
• Biliary Tract Infections: In patients with biliary obstruction or hepatobiliary disease, Aeromonas spp. can ascend the biliary tree and cause cholangitis or cholecystitis. Clinical features include right upper quadrant pain, jaundice, fever, and septicemia.

Conclusion:

Aeromonas spp. infections can present with a spectrum of clinical features, ranging from mild gastroenteritis to severe systemic infections. Recognizing the diverse manifestations of Aeromonas spp. infections is crucial for timely diagnosis and appropriate management. Clinicians should consider Aeromonas spp. as a potential etiology, particularly in individuals with exposures to contaminated water, traumatic injuries, or underlying immunocompromising conditions.

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