Necrotizing Fasciitis Secondary to Aeromonas Infection Presenting with Septic Shock

Abstract

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.

Necrotizing Fasciitis Caused by Aeromonas hydrophila With Catastrophic Progression

“…As reported in a previous study, platelets induce cytokine release, which incites inflammatory response, while the liver produces thrombopoietin that is responsible for platelet growth and development. 2 Therefore, hepatic dysfunction due to liver cirrhosis can decrease immune response to an infection.…”

Necrotizing fasciitis secondary to lake water inoculation with Aeromonas sobria

“…These necrotizing infections have previously been reported to involve individuals with predisposing factors of poorly-controlled diabetes mellitus, hematological malignancies, or immunocompromised status. [ 11 , 12 ] Herein, we present a unique case of a healthy, nondiabetic female who developed NF secondary to contamination of an open wound with lake water.…”