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Pasteurella multocida ecthyma complicated by necrotizing fasciitis.

Nima Milani-Nejad1, Kelly Tyler, Carmine A Grieco

  • 1Medical Scientist Training Program, Ohio State University Wexner Medical Center, Columbus, Ohio, Department of Internal Medicine, Division of Dermatology, Ohio State University Wexner Medical Center, Columbus, Ohio. nima.milaninejad@osumc.edu.

Dermatology Online Journal
|May 26, 2017
PubMed
Summary

Necrotizing fasciitis, a severe soft tissue infection, can rarely be caused by Pasteurella multocida. This case highlights a patient with diabetes and myeloproliferative disorder who developed this serious infection after a cat bite.

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Area of Science:

  • Infectious Diseases
  • Dermatology
  • Microbiology

Background:

  • Necrotizing fasciitis is a rapidly progressive, life-threatening soft tissue infection.
  • Pasteurella multocida is an uncommon pathogen implicated in severe skin and soft tissue infections, typically associated with animal bites.
  • Patients with underlying conditions like diabetes mellitus and myeloproliferative disorders may be at increased risk for severe infections.

Observation:

  • A female patient with a history of diabetes mellitus and myeloproliferative disorder presented with bullae and erythema on her right forearm.
  • The patient's symptoms were attributed to Pasteurella multocida infection, potentially acquired from a cat bite.
  • Clinical and diagnostic imaging confirmed the development of necrotizing fasciitis despite appropriate antibiotic therapy.

Findings:

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  • Early surgical intervention, including irrigation and debridement, was crucial for managing the necrotizing fasciitis.
  • A split-skin graft was successfully employed for wound reconstruction.
  • The patient demonstrated a positive clinical outcome with wound healing following surgical procedures and intravenous antibiotic treatment.

Implications:

  • This case underscores the importance of considering Pasteurella multocida in the differential diagnosis of severe soft tissue infections, especially in patients with relevant exposure history.
  • Prompt recognition and aggressive management, including surgical debridement and antibiotics, are critical for improving outcomes in necrotizing fasciitis.
  • Further research may elucidate specific risk factors and optimal treatment strategies for Pasteurella multocida-induced necrotizing fasciitis.