A fatal case of necrotizing fasciitis due to bacterial translocation of Klebsiella oxytoca.
We report a 73-year-old man with hepatocellular cell carcinoma who had eruptions on and severe pain in the lower leg. Within several hours, the patient's skin lesions had progressed markedly. Magnetic resonance imaging findings were consistent with necrotizing fasciitis. Klebsiella oxytoca was isolated from cultures of biopsy samples taken from the leg. The resulting DNA fingerprint pattern revealed that the enteric bacterium was the same as that obtained from the biopsy samples taken from the leg. Furthermore, a dendrogram showed that genetic proximity between samples was extremely high. These results confirmed that translocation of Klebsiella oxytoca as an enteric pathogen caused the necrotizing fasciitis in this patient.
Oishi
Hirotaka
H
Ariake Sea Research Project, Saga University, 5-1-1 Nabeshima, Saga, Japan. ooishih@cc.saga-u.ac.jp
Kagawa
Yoshihiko
Y
Mitsumizo
Shinji
S
Tashiro
Yukihiro
Y
Kobayashi
Genta
G
Udo
Kazuma
K
Aoki
Shigehisa
S
Takayanagi
Megumi
M
Nagasawa
Zenzo
Z
Araki
Kazukuni
K
Ohza
Noriko
N
Eguchi
Yuichiro
Y
Nakashima
Mikio
M
D000368:Aged; D018988:Bacterial Translocation; D006528:Carcinoma, Hepatocellular / Q000150:complications*; D004269:DNA, Bacterial / Q000235:genetics; D004275:DNA, Ribosomal / Q000235:genetics; D016521:Electrophoresis, Gel, Pulsed-Field; D019115:Fasciitis, Necrotizing / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology; D005243:Feces / Q000382:microbiology; D006801:Humans; D007710:Klebsiella Infections / Q000175:diagnosis*; D041121:Klebsiella oxytoca / Q000235:genetics / Q000302:isolation & purification; D007866:Leg / Q000382:microbiology / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008826:Microbial Sensitivity Tests; D008969:Molecular Sequence Data; D012336:RNA, Ribosomal, 16S / Q000235:genetics; D012867:Skin / Q000382:microbiology; D017211:Treatment Failure
D004269:DNA, Bacterial; D004275:DNA, Ribosomal; D012336:RNA, Ribosomal, 16S