Aeromonas hydrophila Folliculitis Associated with an Inflatable Swimming Pool: Mimicking Pseudomonas aeruginosa Infection

Aeromonas species are ubiquitous, facultative, anaerobic, gram-negative flagellated rods, mainly found in aquatic ecosystems worldwide. Skin and soft-tissue infections, including cellulitis and wound infections, are the second most frequent location of isolations of Aeromonas spp. in clinical samples, after the gastrointestinal tract. All three major Aeromonas species (A. hydrophila, A. caviae, and A. veroni biotype sobria) have been associated with wound infections, but A. hydrophila predominates. Typically, infection occurs after trauma and subsequent exposure to contaminated fresh water or soil. However, Aeromonas folliculitis has been rarely reported. We report the first two pediatric cases of Aeromonas hydrophila folliculitis associated with the use of recreational water facilities that clinically and epidemiologically mimic Pseudomonas folliculitis. Clinical and microbiological studies may be necessary to clarify the role of Aeromonas spp. in this newly-reported infection.