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Necrotizing fasciitis and myonecrosis “synergistic necrotizing cellulitis” caused by Bacillus cereus
Author(s) -
SADA Asuka,
MISAGO Noriyuki,
OKAWA Takeshi,
NARISAWA Yutaka,
IDE Shuya,
NAGATA Masaki,
MITSUMIZO Shinji
Publication year - 2009
Publication title -
the journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.9
H-Index - 65
eISSN - 1346-8138
pISSN - 0385-2407
DOI - 10.1111/j.1346-8138.2009.00669.x
Subject(s) - fasciitis , medicine , cellulitis , gas gangrene , disseminated intravascular coagulation , erythema , surgery , fascia , debridement (dental) , sepsis , bacillus cereus , lesion , genetics , bacteria , biology
Our patient was a 37‐year‐old man with diabetes mellitus and hepatopathy as underlying diseases. Swelling, erythema and pain appeared in the left upper limb on the day before the initial examination. On examination, diffuse purpura was noted on the left upper limb, and, as it rapidly extended to the left upper trunk, emergency surgery was performed. Intraoperatively, gas‐producing necrosis was observed not only in subcutaneous tissues but also from the fascia to muscle tissues, and the condition resembled clostridial gas gangrene. However, as the culturing of samples from the lesion yielded Bacillus cereus , a diagnosis of necrotizing fasciitis and myonecrosis (synergistic necrotizing cellulitis) due to B. cereus was made. While the patient developed a serious condition due to sepsis and disseminated intravascular coagulation, he could be saved by early debridement and intensive treatment with an appropriate selection of antibiotics.