A Fatal Case of Multidrug Resistant Acinetobacter Necrotizing Fasciitis: The Changing Scary Face of Nosocomial InfectionReportar como inadecuado




A Fatal Case of Multidrug Resistant Acinetobacter Necrotizing Fasciitis: The Changing Scary Face of Nosocomial Infection - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.

Case Reports in Infectious Diseases - Volume 2014 2014, Article ID 705279, 6 pages -

Case Report

Division of Pulmonary and Critical Care Medicine, Bronx Lebanon Hospital Center, Albert Einstein College of Medicine, Bronx, NY 10457, USA

Albert Einstein College of Medicine, Department of Pathology, Bronx Lebanon Hospital Center, Bronx, NY 10457, USA

Received 23 June 2014; Accepted 18 September 2014; Published 2 October 2014

Academic Editor: Larry M. Bush

Copyright © 2014 Nupur Sinha et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Necrotizing fasciitis is an uncommon soft-tissue infection, associated with high morbidity and mortality. Early recognition and treatment are crucial for survival. Acinetobacter baumannii is rarely associated with necrotizing fasciitis. Wound infections due to A. baumannii have been described in association with severe trauma in soldiers. There are only sporadic reports of monomicrobial A. baumannii necrotizing fasciitis. We report a unique case of monomicrobial necrotizing fasciitis caused by multidrug resistant MDR A. baumannii, in absence of any preceding trauma, surgery, or any obvious breech in the continuity of skin or mucosa. A 48-year-old woman with history of HIV, asthma, hypertension, and tobacco and excocaine use presented with acute respiratory failure requiring mechanical ventilation. She was treated for pneumonia for 7 days and was successfully extubated. All septic work-up was negative. Two days later, she developed rapidly spreading nonblanching edema with bleb formation at the lateral aspect of right thigh. Emergent extensive debridement and fasciotomy were performed. Operative findings and histopathology were consistent with necrotizing fasciitis. Despite extensive debridement, she succumbed to septic shock in the next few hours. Blood, wound, and tissue cultures grew A. baumannii, sensitive only to amikacin and polymyxin. Histopathology was consistent with necrotizing fasciitis.





Autor: Nupur Sinha, Masooma Niazi, and Dmitry Lvovsky

Fuente: https://www.hindawi.com/



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