Our sympathies go out to the populations affected by the unfortunate climate events in Texas, Nepal, India, Bangladesh, Yemen and Niger. In the coming days, it will be important for the medical community and public health officials to stay vigilant to potential infectious disease complications associated with these natural disasters. The next few cases highlight some potential flood-associated infectious disease consequences.

The cases this week were submitted by Ahmed Babiker, MBBS 1st Year ID Fellow at Pitt.

Case 3

A previously 33-year-old male presents to the emergency room in Beaumont, TX with a 3-day history of fevers, pain and swelling of his left calf. He has been volunteering during the relief efforts, and while assisting in a rescue operation during the recent floods he sustained a laceration to his left calf.

Physical examination of the left lower extremity revealed a 10 cm laceration overlying the lateral aspect of left calf. The calf is edematous, erythematous and diffusely tender. Crepitation is palpated. The left inguinal and popliteal lymph nodes are enlarged and painful.

An X-ray done to rule out a fracture revealed subcutaneous air in the calf.

Which of the following is the most likely causative organism in this case:

1. Vibiro vulnificus
2. Aeromonus hydrophila
3. Erhusiopathiae rhusiopathiae
4. Mycobaterium marinum