Case Report: Post-traumatic Aeromonas infection causing severe lower limb soft tissue infection-a report of two surviving cases.

We report two cases of severe lower limb soft tissue infection caused by Aeromonas following traumatic injury. A 26-year-old male sustained propeller injury with fractures and developed progressive infection complicated by septic shock and necrotizing fasciitis, requiring left femoral mid-shaft amputation. A 58-year-old male suffered an open tibial plateau fracture and presented with wound infection that resolved after antimicrobial treatment but was followed by tetanus. Both patients had positive cultures for Aeromonas hydrophila (and Aeromonas caviae in the second case) identified via matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) combined with biochemical characterization. Antimicrobial susceptibility testing was performed using the broth microdilution method per CLSI 2024 guidelines, guiding targeted antibiotic therapy. Both patients achieved favorable outcomes after comprehensive management including surgical debridement, targeted antimicrobial treatment, and supportive care, with no recurrence during follow-up. This report summarizes the clinical diagnosis, treatment strategies, and prognosis of post-traumatic Aeromonas infection, highlighting the importance of timely microbiological identification, susceptibility testing, and multidisciplinary intervention for improving outcomes in such cases.