Abstract
Necrotizing fasciitis is a rapidly spreading inflammation of the soft tissue involving the fascia and the subcutaneous tissue. Early and aggressive surgical intervention accompanied with appropriate antibiotics are the key to improve clinical outcome in patients with necrotizing fasciitis. Here, we present the case of a 46-year-old male who presented with acute onset progressive watery diarrhea and fever for one day. The abdominal ultrasound and computed tomography revealed diffuse gallbladder wall thickening with double layer sign, air density at right hepatic lobe and a small bowel edema. An intra-abdominal infection was initially suspected. However, a progressive erythematous change and bullae was found on the left thigh and lower abdomen. Progressed necrotizing fasciitis was suspected. After administration of broad antibiotics and emergency surgical intervention, the septic shock was reversed. Finally, the blood and wound culture reports revealed Bacillus cereus growth. This paper describes the clinical features of necrotizing fasciitis and highlights the Bacillus cereus-induced necrotizing fasciitis for physicians in order to promote timely intervention for septic shock.
Highlights
Necrotizing fasciitis is a rapidly progressing and potentially devastating infection of soft tissues.The high mortality rate was reported to be about 40–60% in previous studies [1,2]
This paper describes the clinical features of necrotizing fasciitis and highlights the Bacillus cereus-induced necrotizing fasciitis for physicians in order to promote timely intervention for septic shock
Necrotizing fasciitis is a uncommon but life-threatening infection characterized by involving the subcutaneous tissue and fascia [3]
Summary
Necrotizing fasciitis is a rapidly progressing and potentially devastating infection of soft tissues. The high mortality rate was reported to be about 40–60% in previous studies [1,2]. The typical symptoms include local swelling and erythema accompanied with fever and pain. The formation of bullae, skin necrosis and crepitus can be identified. Insect bites, surgical incisions are predisposing factors in a healthy host. The disease may progress rapidly in patients with immunosuppression and diabetes mellitus. Early diagnosis, timely surgical intervention and appropriate antibiotics are important tools for physicians to control progression of septic shock. This paper describes the clinical features of necrotizing fasciitis and highlights the Bacillus cereus-induced necrotizing fasciitis for physicians in order to promote timely intervention for septic shock
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