Chromobacterium violaceum infection
Chromobacterium violaceum (C. violaceum) is a bacteria commonly seen in tropical and subtropical areas. Although the infection is rare, it has a high mortality and morbidity rate. Similarly, because of its rarity in other regions, most clinicians are unfamiliar with it. According to the patient, he was briefly submerged in a marshy and muddy rice field after getting into a road traffic accident. On presentation, the patient’s skin and clothes were evidently soiled and contaminated with water. However, he denied swallowing any of the water or soil.
Examination was not significant for any signs of pneumonitis or severe open wounds. Similarly, despite persistent fever, the patient’s general condition remained stable until the 7th day of hospitalisation. However, on the 8th day of hospitalisation, the patient suddenly collapsed and died. Investigations were also significant for haemorrhage in the right iliopsoas muscle, a large compound muscle of the inner hip composed of major muscles, iliacus and psoas. The muscle is the main flexor of the hip joint. Radiographic examination showed fractures of the ight trochanteric femur, left distal femur, bilateral scapula, right thumb, and right lumbar (L1–L4) transverse process, and sixth thoracic vertebral compression fracture.
The patient was given non-steroidal anti-inflammatory drugs and referred for surgical fixation of his femoral fractures
The patient’s cause of death was dissemination of an iliopsoas abscess and infection from C. violaceum bacteremia which led to fatal sepsis. Studies have shown this to be a rare combination of the infection. Exposure to contaminated water and soil, particularly in summers is an important predisposing factor for the bacterial infection. Therefore, it is essential to rule out C. violaceum infections. Especially since the infection rates have significantly increased even in non-tropical countries. The bacterial infection is an endemic in natural aquatic environments. For this reason, doctors in countries, such as Japan are not unfamiliar with the rare infection. This is the first fatal case reported in Japan, which occurred after a road traffic accident.
Source: American Journal of Case Reports
