AUTHOR=Wang Xuejin , Gu Danxia , Zhang Liwei , Wu Yuchen , Zhang Rong , Li Kewei , Ren Haitao 

TITLE=mNGS-identified cellulitis due to quinolone-resistant Edwardsiella tarda: a case report

JOURNAL=Frontiers in Medicine

VOLUME=11

YEAR=2024

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2024.1413561

DOI=10.3389/fmed.2024.1413561

ISSN=2296-858X

ABSTRACT=<p><italic>Edwardsiella tarda</italic> is frequently isolated from aquatic animals and environments. While human infections caused by <italic>E. tarda</italic> are rare, some extraintestinal infections can be severe. This case report describes a patient with cellulitis of the right upper extremity of unknown origin. Metagenomic next-generation sequencing (mNGS) indicated that the patient was infected with <italic>E. tarda</italic>. Antimicrobial susceptibility testing revealed that the isolate was resistant to quinolones and trimethoprim/sulfamethoxazole. The isolate, positive for four virulence genes (<italic>fimA, gadB, mukF</italic>, and <italic>sodB</italic>), was confirmed to be virulent using the <italic>Galleria mellonella</italic> larvae model. Following early pus drainage and a 9-day course of imipenem, the patient ultimately recovered. This case report aimed to illustrate the presentation, diagnosis, and management of uncommon cellulitis caused by drug-resistant, virulent <italic>E. tarda</italic>.</p>