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Necrotizing fasciitis caused by Pseudomonas aeruginosa

Department of Medicine and Therapeutics, Control and Prevention of Infectious Diseases, University of the Ryukyus, Okinawa.
Internal Medicine (Impact Factor: 0.97). 02/2008; 47(6):553-6. DOI: 10.2169/internalmedicine.47.0651
Source: PubMed

ABSTRACT An 85-year-old man patient was admitted to the hospital complaining of fever and bilateral leg pain with swelling and erythema. A laboratory investigation revealed leukocytopenia, thus suggesting sepsis. Gram negative rods were detected in the specimen from the affected skin and empiric antibacterial therapy was initiated. The following day, his symptoms worsened and Pseudomonas aeruginosa was isolated from the blood culture and the skin specimen. Magnetic resonance imaging (MRI) did not show the typical characteristics of necrotizing fasciitis. In spite of intensive medical treatment, the patient's condition became critical, and on day 10 after admission, he died of multiple organ failure. An autopsy revealed necrotizing fasciitis due to P. aeruginosa. This is a rare case and its clinical presentation was atypical. The clinical diagnosis of this infection may be difficult, and therefore such cases warrant the careful attention of physicians.

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    • "Other studies have reported the lesion to occur on the trunk/back as well [3]; however, our patient had the lesion on both lower limbs. The predisposing factors are hematological malignancy, diabetes mellitus, and infancy in majority of the cases [9]. There are two main groups of necrotizing fasciitis depending on microbiology [1]. "
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    ABSTRACT: Necrotizing fasciitis is an uncommon rapidly progressing infection of soft tissue characterized by a severe inflammation of the fascia and soft tissue. The disease is associated with necrosis and subcutaneous gangrene of the inflamed tissue with systemic toxicity that carries a significant mortality unless timely diagnosed and aggressively treated. Monomicrobial necrotizing fasciitis caused by Pseudomonas aeruginosa is an exceptionally uncommon condition with only few cases reported in the literature so far. We are reporting a six-month-old female infant who was previously healthy and who presented with necrotizing fasciitis and isolates Pseudomonas aeruginosa both from the blood and tissue. The child improved after the intensive treatment.
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