Necrotizing fasciitis of thigh associated with Escherichia coli bacteremia in a patient on chronic hemodialysis.
Necrotizing fasciitis is a lethal soft tissue infection for its rapid progression to septic shock. We present a 59-year-old male on chronic hemodialysis (HD). We made the diagnosis of necrotizing fasciitis of the right thigh due to the crepitus from physical examination and subcutaneous emphysema from an X film. He was successfully treated with antibiotics and surgical debridement. The blood and surgical drainage cultures showed Escherichia coli, which is less commonly seen in cutaneous infection. The colonoscopic finding revealed adenomatous polyps. Necrotizing fasciitis in patients on HD requires early diagnosis and aggressive treatment to ensure the favorable clinical outcomes.
Division of Nephrology, Department of Medicine, Taipei Medical University-Wan Fang Hospital, Taipei, Taiwan.
Chung-Te
CT
Liu
Yen-Cheng
YC
Chen
Tso-Hsiao
TH
Chen
Tsong-Yih
TY
Ou
D016470:Bacteremia / Q000188:drug therapy / Q000382:microbiology* / Q000601:surgery; D004926:Escherichia coli / Q000302:isolation & purification*; D004927:Escherichia coli Infections / Q000188:drug therapy / Q000382:microbiology* / Q000601:surgery; D019115:Fasciitis, Necrotizing / Q000382:microbiology* / Q000601:surgery / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000009:adverse effects / Q000379:methods*; D013848:Thigh / Q000473:pathology* / Q000601:surgery; D016896:Treatment Outcome