Plesiomonas - Information for Clinicians
Type of infection
Plesiomonas shigelloides is a facultative anaerobic gram-negative bacillus found in the soil and water.
Sources of infection
- Most infections are thought to come from drinking or swimming in contaminated water or eating raw or undercooked shellfish. Plesiomonas infections has also been associated with travel to tropical regions and exposure to reptiles or tropical fish.
- Secondary transmission through fecal oral contact is thought to occur.
Usual symptoms
- Incubation period is generally 24-48 hours.
- Most often watery diarrhea but can contain mucous or blood. Vomiting is common and abdominal pain and cramping can be prominent. Fever occurs in ~10%.
Duration of illness
- Typically 1-3 days without treatment.
Treatment
- Prevent dehydration and treat electrolyte abnormalities.
- Antibiotics are not necessary for mild and self-limited illness. Data on efficacy of therapy are limited - one study showed decreased duration of diarrhea while another showed no benefit.
- For more severe illness or for immunocompromised patients, fluoroquinolones or trimethoprim sulfamethoxazole may be considered. Ceftriaxone is generally active as well.
Complications
- Occassionally, diarrhea can be severe or prolonged (>14 days in 13%).
- Bacteremia can occur, most often in infants and immunocompromised hosts.
- Other extraintestinal infections have been described, including: cellulitis, abscesses, peritonitis, meningoencephalitis, eye infections, and pneumonia.
Comments
- Wash hands carefully after using the bathroom, changing diapers, and before and after cooking.
- To prevent Plesiomonas, avoid drinking untreated water or uncooked shellfish.
- Avoid swimming pools or water parks until fully recovered.
- People with diarrhea should not prepare food.