Edwardsiella tarda Bacteremia Arising From Infected Necrotizing Pancreatitis in a Patient With Cirrhosis

Edwardsiella tarda (E. tarda) is a rare human pathogen that most commonly causes self-limited gastroenteritis. Invasive infection, including bacteremia, is uncommon but carries substantial mortality, particularly among patients with underlying liver disease. We present a 78-year-old man with multiple comorbidities and previously undiagnosed cirrhosis who was admitted with altered mental status and sepsis. Computed tomography (CT) of the abdomen and pelvis demonstrated acute necrotizing pancreatitis with a large gas-containing peripancreatic collection. Blood cultures and intraoperative abscess cultures grew E. tarda, along with Escherichia coli (E. coli). The patient underwent laparoscopic pancreatic necrosectomy and cholecystectomy and received piperacillin-tazobactam based on susceptibility testing. Blood cultures cleared after surgical intervention, and he improved clinically prior to discharge to a skilled nursing facility. This case highlights infected necrotizing pancreatitis as a rare intra-abdominal source of E. tarda bacteremia and reinforces the need for prompt source control in addition to appropriate antimicrobial therapy.