This report describes a case of necrotizing fasciitis presenting with septic shock due to an Aeromonas infection. The patient cut his foot while mowing the lawn and then spent time in a pool with black mold. He began feeling ill and developed swelling and a quarter-sized black area on his right lower extremity. Despite being hemodynamically unstable with systolic blood pressure in the low 70s, the patient was transferred to our facility from outside hospital 100 miles away. Upon arriving to facility, the patient appeared to be septic and the infected area of skin had grown. Irrigation and debridement were performed and appropriate antibiotic therapy was given; however, the patient subsequently died on hospital day 8. On review of the literature, cases of necrotizing fasciitis due to Aeromonas infection have been treated successfully with the aforementioned therapy; however, there is high mortality associated with these infections, many times related to a delayed diagnosis. Our patient also had multiple poor prognostic factors including hepatic dysfunction and immunosuppression.

Ortner syndrome is vocal cord paralysis secondary to left recurrent laryngeal nerve palsy from atrial dilation. We present the case of a 28 year old woman with metastatic appendicular cancer to the peritoneum and pleura who experienced chest pain, progressive dyspnea and change in vocal quality secondary to esophageal impingement on the recurrent laryngeal nerve. This novel case of "Pseudo-Ortner Syndrome" further demonstrates the susceptibility of the laryngeal nerve to palsy secondary to mechanical impingement stemming from an unlikely distal non cardiac source.