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Rapidly advancing necrotizing fasciitis caused by Photobacterium (Vibrio) damsela: a hyperaggressive variant
Kristen H Goodell1, Michael R Jordan, Roger Graham
1Department of Surgery, Tufts-New England Medical Center, Tufts University School of Medicine, Boston, MA, USA.
Objective:
To describe the first case of Vibrio damsela necrotizing fasciitis in New England, emphasizing the importance of very early operative intervention to achieve source control in this extremely aggressive infection.
Design:
Case report.
Setting:
Surgical intensive care unit at Tufts-New England Medical Center in Boston, MA.
Patient:
A 69-yr-old retired fisherman with rapidly progressive necrotizing fasciitis from Photobacterium (Vibrio) damsela infection and ensuing multiple-system organ failure.
Interventions:
Surgical debridement, ventilator support, vasopressors, continuous veno-venous hemofiltration, and blood product transfusions.
Measurements And Main Results:
Death.
Conclusions:
A high index of suspicion is necessary for the diagnosis of this specific pathogen and concordant infection. The willingness to surgically debride and amputate without hesitation at a very early point may be the only intervention capable of saving the lives of patients affected by Photobacterium (Vibrio) damsela.