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.
Tanaka et al. (Thu,) studied this question.