# Takotsubo cardiomyopathy following aeromonas hydrophila septic shock after traumatic injury: a case report

## TL;DR

A patient developed Takotsubo cardiomyopathy after a traumatic injury and a severe Aeromonas hydrophila infection leading to septic shock, and was successfully treated with a combination of therapies.

## Contribution

This case report highlights a rare association between Aeromonas hydrophila septic shock and Takotsubo cardiomyopathy following trauma.

## Key findings

- Takotsubo cardiomyopathy occurred in a patient with Aeromonas hydrophila septic shock and traumatic injury.
- Successful treatment involved antibiotics, surgery, and tailored haemodynamic support.
- Levosimendan was used as an inotropic agent, though no therapeutic efficacy can be inferred from this single case.

## Abstract

Aeromonas hydrophila is a Gram-negative bacillus commonly found in aquatic environments. It is capable of causing skin and soft tissue infections, and in immunocompromised individuals, it may lead to severe systemic infections and septic shock. Takotsubo cardiomyopathy (TTS) is a rare cardiac syndrome typically precipitated by acute stressors.

This report describes a case of a patient who experienced cardiac arrest following trauma sustained in a road traffic accident, complicated by lower limb infection. The infection progressed rapidly, culminating in cardiac arrest. Subsequent investigations supported a diagnosis of TTS occurring in a multifactorial physical stress milieu, including traumatic injury and rapidly progressive soft-tissue infection due to Aeromonas hydrophila with septic shock. The patient was successfully treated with targeted antibiotic therapy, surgical intervention, and individualized haemodynamic support with cautious, congestion-aware fluid management, and was ultimately discharged in a stable condition.

Aeromonas hydrophila infection with septic shock may be one component of a multifactorial physical stress response; together with traumatic injury and severe pain from tissue injury and necrosis, it may precipitate Takotsubo syndrome through acute sympathetic activation and a catecholamine surge. Echocardiography and cardiac magnetic resonance imaging can support the diagnosis. In this case, levosimendan was used as an adjunctive inotropic strategy; however, no causal inference or therapeutic efficacy can be concluded from a single case report.