6533b870fe1ef96bd12cfb6f
RESEARCH PRODUCT
A Difficult Case of Necrotizing Fasciitis Caused By Acinetobacter baumannii
Francesco MoschellaSara Di LorenzoAdriana CordovaBartolo CorradinoFrancesca Toiasubject
Acinetobacter baumanniiInsecticidesmedicine.medical_specialtyMicrobiological culturemedicine.medical_treatmentAcinetobacter Infections/diagnosis Acinetobacter Infections/drug therapy Acinetobacter Infections/microbiology* Acinetobacter baumannii/isolation &Settore MED/19 - Chirurgia PlasticaBoric AcidsmedicineHumansFasciitis NecrotizingFasciitisDebridementbiologybusiness.industrySeptic shockSoft Tissue Infectionspurification* Anti-Infective Agents Local/therapeutic use Boric Acids/therapeutic use Debridement Fasciitis Necrotizing/diagnosis Fasciitis Necrotizing/drug therapy Fasciitis Necrotizing/microbiology* Female Heart Arrest Humans Insecticides/therapeutic use Middle Aged Pseudomonas aeruginosa/isolation &General MedicineEmergency departmentMiddle Agedbiology.organism_classificationmedicine.diseaseShock SepticSilver SulfadiazineHeart ArrestSurgeryAcinetobacter baumanniiPerineummedicine.anatomical_structureDebridementShock (circulatory)Pseudomonas aeruginosapurification Shock Septic Silver Sulfadiazine/therapeutic use Soft Tissue Infections/diagnosis Soft Tissue Infections/drug therapy Soft Tissue Infections/microbiologyAnti-Infective Agents LocalFemaleSurgerymedicine.symptombusinessAcinetobacter Infectionsdescription
This study reports the case of a 55-year-old woman with diabetes with a necrotizing fasciitis of the right lower limb and the perineum, first admitted at the emergency department for septic shock with cardiac arrest, and later transferred to the department of surgery. Microbiological and histopathological examination confirmed the diagnosis of necrotizing fasciitis caused by Acinetobacter baumanii. A broad-spectrum antibiotic therapy was administered and later readjusted according to the results of microbiological culture. Intensive hemodynamic support was required. Wounds were dressed daily with a 3 percent boric acid solution and a silver sulfadiazine-impregnated dressing. An extensive surgical debridement was promptly performed and repeated until complete control of the infection. Wounds were finally covered with split-thickness skin grafts. The infection was overcome 35 days after admission. The graft take was 100%. Postoperative rehabilitation was required because of the functional limitation of lower limb movements. Follow-up at 6 months showed no functional deficit and an acceptable aesthetic result. Necrotizing fasciitis is a life-threatening disorder, especially in patients with diabetes, whose clinical diagnosis may sometimes be challenging. Early recognition and treatment represent the most important factors influencing survival.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2010-12-08 | The International Journal of Lower Extremity Wounds |