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.
"The most common bacteria associated with necrotizing fasciitis is group A streptococcus, however, other pathogens, including Clostridium, Vibrio vulnificus and Bacteroides fragilis have been implicated (1). Pseudomonas is a rare pathogen that causes necrotizing fasciitis (2). In the present study, a case of community-acquired necrotizing fasciitis with septic shock due to Pseudomonas aeruginosa is presented, as well as a review of the literature on the current therapeutic strategies for this condition. "
[Show abstract][Hide abstract] ABSTRACT: Necrotizing fasciitis is a rare but fatal infection, characterized by the rapid progression of necrosis of the fascia, skin, soft tissue and muscle. The most common bacteria associated with necrotizing fasciitis is group A streptococcus, although other pathogens have also been implicated. In the present study, a case of community-acquired necrotizing fasciitis, complicated with septic shock and multiple organ dysfunction syndromes due to Pseudomonas aeruginosa, is presented. Despite intensive medical treatment, the condition of the patient deteriorated rapidly and the patient subsequently succumbed to multiple organ failure. In view of the rapid progression and high mortality rate of this disease, early surgery, as well as novel therapeutic approaches for septic shock are required to improve the outcome for patients.
Experimental and therapeutic medicine 06/2014; 7(6):1545-1548. DOI:10.3892/etm.2014.1628 · 1.27 Impact Factor
"Other studies have reported the lesion to occur on the trunk/back as well ; 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 . There are two main groups of necrotizing fasciitis depending on microbiology . "
[Show abstract][Hide abstract] 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.
[Show abstract][Hide abstract] ABSTRACT: Three cases of periorbital necrotising fasciitis are described, one occurring in a three-year-old child. The cases in adults required debridement of necrotic tissue, in one of whom there was extensive disease involving the face and orbital fat. It is probable that the early stages of this condition are under-recognised; the importance of early signs and intensive treatment of this life-threatening disease are illustrated.
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