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Necrotizing fasciitis and infective endocarditis caused by E scherichia coli in a hemodialysis patient
Author(s) -
Tsai MingHsien,
Leu JyhGang,
Fang YuWei,
Hsieh ShihChung
Publication year - 2015
Publication title -
hemodialysis international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.658
H-Index - 47
eISSN - 1542-4758
pISSN - 1492-7535
DOI - 10.1111/hdi.12264
Subject(s) - medicine , fasciitis , infective endocarditis , hemodialysis , endocarditis , uremia , debridement (dental) , surgery , dialysis
Abstract Patients with uremia are often immunocompromised and uremia patients undergoing maintenance dialysis are often vulnerable to uncommon infections. We report a 40‐year‐old man who was undergoing maintenance hemodialysis and was initially diagnosed with monomicrobal necrotizing fasciitis of the lower limbs, based on blood and pus cultures that yielded E scherichia coli . His condition improved after surgical debridement and antibiotic therapy. However, he eventually died of intracranial hemorrhage related to septic emboli. Concurrent infective endocarditis was diagnosed based on an echocardiogram that indicated vegetation in the left ventricular region. E scherichia coli ‐related necrotizing fasciitis and infective endocarditis is rarely seen in clinical practice. There should be a high index of suspicion for multiple infections when a hemodialysis patient presents with an uncommon infection.