title: Necrotizing fasciitis and myonecrosis "synergistic necrotizing cellulitis" caused by Bacillus cereus.
abstract: 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.
authors: Division of Dermatology, Department of Internal Medicine, Saga University, 5-1-1 Nabeshima, Saga City, Saga 849-8501, Japan. sadaasu@cc.saga-u.ac.jp
authors: Asuka
authors: A
authors: Sada
authors: Noriyuki
authors: N
authors: Misago
authors: Takeshi
authors: T
authors: Okawa
authors: Yutaka
authors: Y
authors: Narisawa
authors: Shuya
authors: S
authors: Ide
authors: Masaki
authors: M
authors: Nagata
authors: Shinji
authors: S
authors: Mitsumizo
mesh_terms: D000328:Adult; D016863:Bacillaceae Infections / Q000175:diagnosis* / Q000382:microbiology / Q000628:therapy; D001409:Bacillus cereus / Q000302:isolation & purification / Q000472:pathogenicity*; D002481:Cellulitis / Q000175:diagnosis* / Q000382:microbiology / Q000628:therapy; D019115:Fasciitis, Necrotizing / Q000175:diagnosis* / Q000382:microbiology / Q000628:therapy; D006801:Humans; D008297:Male; D009220:Myositis / Q000175:diagnosis* / Q000382:microbiology / Q000628:therapy; D009336:Necrosis