Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 20 2 2026 09 13 146 148 Uday Modi Department of General Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India Nitin Gupta Department of Infectious Diseases, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India Muralidhar Varma Department of Infectious Diseases, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India Akhila Vasudeva Department of Obstetrics and Gynecology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India Praveen Tirlangi Department of Infectious Diseases, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India 2026 05 10 2026 08 05 Objective: To report a rare case of Edwardsiella tarda bacteremia in early pregnancy complicated by maternal sepsis, sepsis-induced coagulopathy, acute kidney injury, and intrauterine fetal demise. Case Report: A 32-year-old woman at 13 weeks of gestation presented with sudden-onset high-grade fever, abdominal pain, and vaginal bleeding shortly after consuming freshwater fish. She had no preceding diarrhea or vomiting. During hospitalization, she developed persistent fever, anemia, thrombocytopenia, acute kidney injury, and coagulopathy, with a sepsis-induced coagulopathy score of 5. Obstetric ultrasonography confirmed absence of fetal cardiac activity, and emergency vacuum aspiration was performed. Blood cultures grew Edwardsiella tarda, while stool cultures were sterile. She was treated with intravenous piperacillin-tazobactam, fluid resuscitation, oxygen supplementation, and blood transfusion. Her fever subsided, renal function and coagulation parameters normalized, and she was discharged in stable condition. Conclusion: Invasive Edwardsiella tarda infection during pregnancy is extremely uncommon but may cause severe maternal sepsis and adverse fetal outcome even without gastrointestinal symptoms. Recent freshwater fish exposure may provide an important diagnostic clue. Early blood culture sampling, prompt antimicrobial therapy, and supportive care are essential for maternal recovery. https://jfrh.tums.ac.ir/index.php/jfrh/article/view/3731 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/3731/765