Review for 10.1186/s12876-020-01446-1 (2020)

Reviewer’ s report
Title: Gastric submucosal abscess caused by Edwardsiella tarda infection: a case report
Version: 1Date: 31 Jul 2020
Reviewer's report:This case report describes a case of Edwardsiella Tarda septicemia, presumably caused by a
submucosal abscess due to the same pathogen. This clinical case is quite peculiar and is therefore
interesting for other gastro-enterologists. A few questions arise, which should be addressed:
1.As it appears, the patient presented with several problems at the same time: 1.
Choledocholithiasis, 2. Intra-abdominall abscess, 3. Submucosal abscess, and 4. Septicaemia.Although the abscesses and septicaemia seem to be linked and the main reasons for presentation tothe emergency ward, the obstructive choledocholithiasis almost seems to be a co-incidentalfinding in this particular patient. Do the authors agree or do they think that the icteric presentationwas also due to, or exacerbated by, E tarda infection? If so, what would be the proposedmechanism? Please explain the relationship of clinical findings some more in the manuscript.
2.The abscess seems to be very large in relation to only a 4-day history of abdominal pain,
vomiting and appetite loss. Do the authors have any clues that could indicate a longer presence ofcomplaints? And do they have any ideas how this infection might have been introduced in thispatient (maybe based on social anamnesis)?
3.It seems that 3 days passed between CT-based diagnosis and drainage of the abscess. What were
the clinical considerations and how did the patient's condition change during this time frame?
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Is the study design appropriate to answer the research question (including the use of appropriate
controls), and are the conclusions supported by the evidence presented?
YesAre the methods sufficiently described to allow the study to be repeated?Yes
Is the use of statistics and treatment of uncertainties appropriate?
Yes
Is the presentation of the work clear?NoAre the images in this manuscript (including electrophoretic gels and blots) free from apparent
manipulation?
Yes