Shewanella soft tissue infection: case report and literature review

Objective: To better understand the clinical characteristics of soft tissue infections caused by Shewanella in humans. Methods: We report a case of Shewanella soft tissue infection and review the English literature from a search of PubMed. Results: A total of 27 adults (mean age 61.1 ± 16.0 years) with soft tissue infections caused by Shewanella were included for analysis. Limb involvement was found in 22 (81.5%) patients, while scalp, face, perineum, lacrimal sac, and abdominal wall involvement were each found in one patient. Chronic ulcer over the leg (14 cases (51.9%)), steroid use (four cases (14.8%)), and liver cirrhosis (three cases (11.1%)) were the major underlying conditions. Shewanella bacteremia was found in 14 out of 22 patients with soft tissue infections involving the limbs. Two patients died of septicemia, giving a mortality rate of 7.4%. Conclusions: Shewanella soft tissue infections usually develop in immunocompromised patients with a preexisting cutaneous ulcer (particularly over the legs) after marine environment or seawater exposure. In view of the possible catastrophic consequences, education on the prevention of Shewanella soft tissue infections in at-risk people (e.g., the immunocompromised or elderly with a cutaneous ulcer) relating the need to avoid exposure to the marine environment or seawater may be of importance.