Aeromonas hydrophila in a Burn Patient Ahmet Cinar Yasti, MD,* Emrah Otan, MD,† Mutlu Doganay, MD,† Nuri A. Kama, MD† Infectious consequences are still a major problem and leading cause of mortality in burn patients. Among others, aeromonads need special concern because they mimic pseudomonal infections; however, they have a more rapid progression with considerable mortality if undi- agnosed promptly. Here, we present a major burn case extinguished with tap water pooled in a tank. With the possibility of aeromonal infection in mind, the patient underwent ag- gressive debridement with proper antibiotic medication, which resulted in a successful pa- tient management. Aeromonads should always be kept in mind in burn cases that contacted with tanked water or soil after the burn. (J Burn Care Res 2009;30:898 –900) Despite recent advances in burn care, which lead to significantly better survival rates, infections remain the leading cause of mortality among patients who are hospitalized for burns. It has been estimated that at least 50% of all deaths caused by burns are the result of wound infections. 1 The incidence of invasive burn wound sepsis is proportional to the extent of the burn and is influenced by the depth of the burn, age of the patient, and length of time the wound remains open. 1,2 Aeromonads are members of the Vibrionaceae family and are Gram negative, usually 1 to 3 m in length, nonsporulating facultative anaerobic rods that are -hemolytic on blood agar and ferment car- bohydrates with acid and gas production. Aeromonas species are oxidase positive, and they exhibit motility by means of a polar flagellum. 3,4 The normal habitat of Aeromonas is the aquatic environment. 5 They are found in freshwater and brackish water as well as in nonfecal organic material. Isolates have been recov- ered from fish tanks, swimming pools, and tap water, including hospital water supplies and soil. 3,5–7 Aero- monas can also be isolated from the stools of asymp- tomatic individuals. 4 Three Aeromonas species are pathogenic for hu- mans, Aeromonas caviae, Aeromonas hydrophila, and Aeromonas sobria. Human infections caused by these species include acute gastrointestinal illness, soft tis- sue infections, sepsis, frequently in association with malignancies and cirrhosis, and other miscellaneous infections, including pneumonia, meningitis, endo- carditis, septic arthritis, and osteomyelitis. 3,8 Expo- sure to water after a soft tissue trauma seems to be the principal factor involved in the pathogenesis of soft tissue infections caused by A. hydrophila. Aeromonas bacteremia in burn patients is partic- ularly rare. In our English literature search, there are 26 reported cases identified and has limited series. 9 –14 Case A 33-year-old previously healthy man involved in a liquid propane gas cylinder explosion. He sustained a 30% TBSA burns to the face, neck, arms, and upper chest, with 15% deep partial or full-thickness burn wounds and a crush injury, including all body parts, where forearms was the most affected part. First aid was given by his friends via extinguishing fire with tap water pooled in a tank. On the day of event, the patient was transferred to and hospitalized in a district hospital where initial resuscitation and fasciotomy that was necessitated for bilateral forearms regarding crush injury had been performed. The patient was then transferred to our burns unit on postburn day 1. After admission, fasciotomies were extended due to hypoperfusion and compartment syndrome. For wound management, the patient was administered daily chlorhexidine baths and silver sulfadiazine From the *Ankara Numune Education and Research Hospital, Burns Treatment Center; and †Department of Surgery, Ankara, Turkey. Address correspondence to Ahmet Cinar Yasti, Ankara Numune Education and Research Hospital, Talatpasa Bulvari, Samanpazari, Ankara 06100, Turkey. Copyright © 2009 by the American Burn Association. 1559-047X/2009 DOI: 10.1097/BCR.0b013e3181b487cf 898