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A subcutaneous infection mimicking necrotizing fasciitis due to Butyricimonas virosa

Laura De Donder1, Ortwin Uyttebroek2, Stijn Van Cleven2

  • 1Ghent University, Ghent, Belgium.

Acta Chirurgica Belgica
|June 18, 2019
PubMed
Abstract

Insights

A rare Gram-negative bacterium, Butyricimonas virosa, caused a subcutaneous infection mimicking necrotizing fasciitis in a patient. Early diagnosis and treatment were crucial for recovery, highlighting the need for better diagnostic tools.

Area of Science:

  • Infectious Diseases
  • Microbiology
  • Surgical Infections

Background:

  • Butyricimonas virosa, a rare Gram-negative rod, was first identified in rats in 2009.
  • Human infections with B. virosa are infrequent, with only six cases reported previously, primarily bacteremia and one bone abscess.

Observation:

  • A 78-year-old male presented with a surgical site infection suspected to be necrotizing fasciitis.
  • Surgical exploration revealed a subcutaneous infection, not necrotizing fasciitis, caused by B. virosa and Finegoldia magna.

Findings:

  • The patient received negative pressure wound therapy (NPWT) and antibiotics (piperacillin-tazobactam and vancomycin).
  • Microbiologic cultures became negative during NPWT, and the patient was discharged after 18 days.

Implications:

  • Differentiating subcutaneous infections mimicking necrotizing fasciitis is challenging.
  • Further research into diagnostic tools like the Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score and CT imaging is needed.
Keywords:
ButyricimonasLRINECanaerobesnecrotizing fasciitisnegative pressure wound therapy

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