A kidney transplant recipient with shingles and necrotizing bacterial superinfection: a case report

We report a 45-year-old kidney transplant recipient who developed primary varicella zoster virus infection complicated by monomicrobial necrotizing skin and soft tissue infection caused by Pseudomonas aeruginosa. Progressive facial and oropharyngeal edema led to airway compromise requiring endotracheal intubation. Blood and wound cultures grew Pseudomonas aeruginosa, and targeted therapy with meropenem resulted in clinical improvement. The patient recovered with preserved allograft function but was left with residual facial nerve palsy. Pseudomonas aeruginosa-associated monomicrobial necrotizing skin and soft tissue infections are rare, occur predominantly in immunocompromised patients, and can be life-threatening.