title: Successful treatment of necrotizing fasciitis in an upper extremity caused by Clostridium perfringens after bone marrow transplantation.
abstract: We report a 47-year-old man with acute leukemia who survived a severe case of necrotizing fasciitis caused by Clostridium perfringens involving his right upper extremity. On day 5 after stem cell transplantation, progressive local tissue necrosis led to septicemia and disseminated intravascular coagulation. Early diagnosis and prompt initiation of appropriate therapy, including surgical debridement and broad-spectrum antibiotics, were crucial. A recombinant thrombomodulin might have not only resolved the coagulation problem but also prevented multiple organ failure associated with the systemic inflammatory response.
authors.affiliation: Department of Hematology, Nephrology, and Rheumatology, Akita University Graduate School of Medicine, Japan.
authors.forename: Mitsugu
authors.initials: M
authors.lastname: Ito
authors.forename: Naoto
authors.initials: N
authors.lastname: Takahashi
authors.forename: Hirobumi
authors.initials: H
authors.lastname: Saitoh
authors.forename: Seiji
authors.initials: S
authors.lastname: Shida
authors.forename: Takayo
authors.initials: T
authors.lastname: Nagao
authors.forename: Masaaki
authors.initials: M
authors.lastname: Kume
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Kameoka
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Tagawa
authors.forename: Naohito
authors.initials: N
authors.lastname: Fujishima
authors.forename: Makoto
authors.initials: M
authors.lastname: Hirokawa
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Tazawa
authors.forename: Takashi
authors.initials: T
authors.lastname: Minato
authors.forename: Shin
authors.initials: S
authors.lastname: Yamada
authors.forename: Kenichi
authors.initials: K
authors.lastname: Sawada
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001132:Arm; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D003646:Debridement; D019115:Fasciitis, Necrotizing / Q000209:etiology* / Q000628:therapy*; D005738:Gas Gangrene / Q000209:etiology* / Q000628:therapy*; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011994:Recombinant Proteins / Q000627:therapeutic use; D018180:Thrombomodulin / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D016756:Immunoglobulins, Intravenous; D011994:Recombinant Proteins; C546931:THBD protein, human; D018180:Thrombomodulin