Edwardsiella tarda Bacteremia in Early Pregnancy Complicated by Maternal Sepsis and Intrauterine Fetal Demise: A Case Report

Abstract

Objective: To report a rare case of Edwardsiella tarda bacteremia in early pregnancy complicated by maternal sepsis, sepsis-induced coagulopathy, acute kidney injury, and intrauterine fetal demise.

Case Report: A 32-year-old woman at 13 weeks of gestation presented with sudden-onset high-grade fever, abdominal pain, and vaginal bleeding shortly after consuming freshwater fish. She had no preceding diarrhea or vomiting. During hospitalization, she developed persistent fever, anemia, thrombocytopenia, acute kidney injury, and coagulopathy, with a sepsis-induced coagulopathy score of 5. Obstetric ultrasonography confirmed absence of fetal cardiac activity, and emergency vacuum aspiration was performed. Blood cultures grew Edwardsiella tarda, while stool cultures were sterile. She was treated with intravenous piperacillin-tazobactam, fluid resuscitation, oxygen supplementation, and blood transfusion. Her fever subsided, renal function and coagulation parameters normalized, and she was discharged in stable condition.

Conclusion: Invasive Edwardsiella tarda infection during pregnancy is extremely uncommon but may cause severe maternal sepsis and adverse fetal outcome even without gastrointestinal symptoms. Recent freshwater fish exposure may provide an important diagnostic clue. Early blood culture sampling, prompt antimicrobial therapy, and supportive care are essential for maternal recovery.