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Published on: December 20, 2018
Necrotizing Fasciitis Secondary to Aeromonas Infection Presenting with Septic Shock
Nikhil Bhatia1, Manuel Castro-Borobio2, John N Greene3
1University of South Florida Morsani College of Medicine, 12901 Bruce B. Downs Blvd, Tampa, FL 33612, USA.
Abstract:
This report describes a case of necrotizing fasciitis presenting with septic shock due to an Aeromonas infection. The patient cut his foot while mowing the lawn and then spent time in a pool with black mold. He began feeling ill and developed swelling and a quarter-sized black area on his right lower extremity. Despite being hemodynamically unstable with systolic blood pressure in the low 70s, the patient was transferred to our facility from outside hospital 100 miles away. Upon arriving to facility, the patient appeared to be septic and the infected area of skin had grown. Irrigation and debridement were performed and appropriate antibiotic therapy was given; however, the patient subsequently died on hospital day 8. On review of the literature, cases of necrotizing fasciitis due to Aeromonas infection have been treated successfully with the aforementioned therapy; however, there is high mortality associated with these infections, many times related to a delayed diagnosis. Our patient also had multiple poor prognostic factors including hepatic dysfunction and immunosuppression.
Insights
Necrotizing fasciitis caused by Aeromonas infection can lead to septic shock. Prompt diagnosis and treatment are crucial for survival, though mortality remains high, especially with risk factors.
Area of Science:
- Infectious Diseases
- Critical Care Medicine
- Dermatology
Background:
- Necrotizing fasciitis is a severe soft tissue infection.
- Aeromonas species are Gram-negative bacteria that can cause opportunistic infections.
Observation:
- A patient presented with septic shock and necrotizing fasciitis after a foot injury and exposure to contaminated water.
- Clinical signs included lower extremity swelling and a rapidly progressing necrotic lesion.
- The patient was hemodynamically unstable upon transfer, indicating severe sepsis.
Findings:
- Despite surgical intervention (irrigation and debridement) and antibiotic therapy, the patient succumbed to the infection.
- Literature review indicates successful treatment outcomes in other Aeromonas-related necrotizing fasciitis cases.
- High mortality is associated with delayed diagnosis and patient factors like hepatic dysfunction and immunosuppression.
Implications:
- This case highlights the aggressive nature of Aeromonas-induced necrotizing fasciitis.
- Early recognition and aggressive management are critical for improving patient outcomes.
- Public health awareness regarding wound care and potential environmental exposures is important.
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