Aeromonas hydrophila Bacteremia in an Immunocompromised Patient

Aeromonas hydrophila (A. hydrophila) is a facultative anaerobic, Gram-negative, water-dwelling bacterium that can cause a wide range of infections, including bacteremia, especially in immunocompromised patients. This report presents the case of a 68-year-old female patient with a history of renal transplant and chronic immunosuppression, who developed bacteremia caused by A. hydrophila after being exposed to raw crab. Initial presentation included an acute kidney injury and gastrointestinal symptoms, but she had an abnormal clinical course, as she did not have a fever or leukocytosis. Empiric piperacillin-tazobactam was initiated, then later de-escalated to intravenous (IV) ceftriaxone and oral doxycycline following susceptibility testing. This treatment led to a swift recovery. The case presentation emphasizes the importance of having a high index of suspicion in immunocompromised patients, as they may present atypically. A thorough history, including exposure history, is vital for proper identification of rare pathogens such as A. hydrophila. Appropriate treatment following diagnosis is vital to reduce morbidity and mortality associated with Aeromonas bacteremia.