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An Unusual Suspect in a Case of Fungal Necrotizing Soft Tissue Infection
1Surgery, William Carey University College of Osteopathic Medicine, Hattiesburg, USA.
Abstract:
Necrotizing soft tissue infection (NSTI) is a rapidly progressive and potentially fatal infection that is most commonly bacterial in origin but can also be fungal. We present the case of a 79-year-old woman who developed NSTI after gastrostomy tube (G-tube) manipulation. She presented to the emergency department (ED) with abdominal pain and inflammation, and imaging revealed the G-tube to be positioned within the soft tissues. The patient then underwent emergent surgical debridement while decompensating from septic shock. Tissue cultures identified an unusual combination of Pichia and Lactobacillus species. The patient improved with repeated debridement and targeted antimicrobial therapy. This case highlights the importance of considering atypical and fungal sources of NSTI, especially in immunocompromised patients, as well as the critical nature of urgent surgical intervention.
Insights
Necrotizing soft tissue infection (NSTI) can be fungal. A case report details a 79-year-old woman with NSTI caused by Pichia and Lactobacillus species after gastrostomy tube manipulation, emphasizing urgent surgical care.
Area of Science:
- Infectious Diseases
- Mycology
- Surgical Pathology
Background:
- Necrotizing soft tissue infection (NSTI) is a severe, rapidly progressing infection, often bacterial but with potential fungal origins.
- Gastrostomy tube (G-tube) manipulation can predispose patients to localized infections.
- Fungal and polymicrobial infections are less common causes of NSTI but can be life-threatening.
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