Summertime has come again in our lovely sunshine state. Today I want to tell you about an organism that can cause a severe infection after traumatic marine wounds. This article is to remind you of one of the dangers lurking in both our freshwater environments such as ponds, lakes, and rivers, as well as brackish waters. It grows best in warmer climates and can grow both aerobically (survive and grow in oxygenated environments) and anaerobically (does not require oxygen to grow). The microorganism or bacterium referred to is named Aeromonas hydrophilia, a ubiquitous gram-negative bacillus that loves water, just like the name says. It also causes illness in fish, reptiles, and amphibians, so use caution when handling. The organism can also cause gastrointestinal complications for persons with watery or bloody diarrhea if contaminated water is ingested.
The most common infections occur in the lower extremities or hands and may be sustained in activities like wading, swimming, fishing, and boating. Contributing factors include the severity of the injury, the virulence of the strain, and the person’s immune status. Examples of injuries include an abrasion that gets submerged in a fish tank, a boating accident, or a blunt trauma while fishing, diving, or water skiing. It could be an injury from sharp fish fins or a boat propeller. Broken skin is the way the organism enters the body when there is contact with the water that contains the organism. On a rare note, the organism can also be transmitted by certain leeches that are used in specialty wound care.
The symptoms typically start within about 8 hours after exposure. The symptoms may appear mild at first but worsen quickly. Symptoms may include fever, pain, warmth, and a foul fishy odor. If the infection spreads to the bloodstream, studies suggest a mortality range from 29 to 73%. Tips for prevention include rapid general first aide. Apply pressure to any bleeding wound, examine the site for gross contamination and foreign bodies. Remove anything constricting to the area, such as jewelry. Cleanse the wound and periphery with soap and water, bottled water is acceptable. Leave the wound open to air. Finally, cover wound with a dry dressing, watch for signs of infection, seek help if there is concern for infection and notify your provider of what happened.
Aeromonas hydrophilia can be killed with appropriate antimicrobial therapy such as TMP-SMX trimethoprim sulfamethoxazole OR Gentamicin with Tetracycline. First aid is your best first mechanism of defense. Keeping a first aid kit handy when doing these kinds of activities. Time to treatment is essential. If not properly treated you may need to undergo surgical debridement of necrotic tissue, then begin the proper coverage. Stay safe this summer and if you need to see a physician visit https://providers.steward.org.
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