Fatal Edwardsiella tarda Sepsis in a Patient with End-stage Multiple Myeloma: A Case of Suspected Zoonotic Transmission
Abstract
Edwardsiella tarda is an opportunistic aquatic pathogen that rarely causes human bacteremia, but it carries high mortality, particularly in immunocompromised hosts. We report the fatal case of a 74-year-old man with refractory multiple myeloma (MM) and profound iatrogenic immunodeficiency who developed septic shock shortly after acquiring tropical fish. Despite the isolate's susceptibility to administered broad-spectrum antibiotics, including meropenem, the patient died within 72 hours of admission. This report highlights the lethal synergy between modern anti-myeloma therapies, specifically the cumulative immunosuppression from proteasome inhibitors, immunomodulatory drugs, anti-CD38 monoclonal antibodies, and the virulence factors of E. tarda. We provide a detailed clinical course and comparative discussion of hematological cases in Japan. This case underscores the critical need for thorough environmental history-taking and specific counseling for profoundly immunocompromised patients regarding the risks of exotic pet ownership.
Related
- The impacts of host community composition, clustering and vector host choice on zoonotic mosquito-borne virus transmission
- An Atypical Abdominal Presentation of Pancreatic Panniculitis in a Patient With Suspected Pancreatic Cancer: A Case Report
- Successful Treatment with Rituximab in a Patient with Clinically Suspected Small-vessel Primary Central Nervous System Vasculitis Refractory to Cyclophosphamide Pulse Therapy
- Inferolateral ST-Segment Elevation Myocardial Infarction Secondary to Suspected Coronary Embolism in a Patient with Paroxysmal Atrial Fibrillation: A Case Report.
- Incidental left atrial appendage aneurysm with suspected left ventricular fistulous communication in a patient with metastatic non-small cell lung cancer
BibTeX
@article{tanaka2026fatal,
title = {{Fatal Edwardsiella tarda Sepsis in a Patient with End-stage Multiple Myeloma: A Case of Suspected Zoonotic Transmission}},
author = {Yuka Tanaka and Keita Sugihara and Ryota Minami and Mioka Matsumoto and Norimitsu Saitoh},
journal = {Internal Medicine},
year = {2026},
month = nov,
doi = {10.2169/internalmedicine.6545-25},
url = {https://www.jstage.jst.go.jp/article/internalmedicine/65/21/65_6545-25/_article},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Fatal Edwardsiella tarda Sepsis in a Patient with End-stage Multiple Myeloma: A Case of Suspected Zoonotic Transmission
AU - Yuka Tanaka
AU - Keita Sugihara
AU - Ryota Minami
AU - Mioka Matsumoto
AU - Norimitsu Saitoh
PY - 2026
DA - 2026/11/01
JO - Internal Medicine
DO - 10.2169/internalmedicine.6545-25
UR - https://www.jstage.jst.go.jp/article/internalmedicine/65/21/65_6545-25/_article
AB - Edwardsiella tarda is an opportunistic aquatic pathogen that rarely causes human bacteremia, but it carries high mortality, particularly in immunocompromised hosts. We report the fatal case of a 74-year-old man with refractory multiple myeloma (MM) and profound iatrogenic immunodeficiency who developed septic shock shortly after acquiring tropical fish. Despite the isolate's susceptibility to administered broad-spectrum antibiotics, including meropenem, the patient died within 72 hours of admission. This report highlights the lethal synergy between modern anti-myeloma therapies, specifically the cumulative immunosuppression from proteasome inhibitors, immunomodulatory drugs, anti-CD38 monoclonal antibodies, and the virulence factors of E. tarda. We provide a detailed clinical course and comparative discussion of hematological cases in Japan. This case underscores the critical need for thorough environmental history-taking and specific counseling for profoundly immunocompromised patients regarding the risks of exotic pet ownership.
SN - 1349-7235
SN - 0918-2918
ER -