title: Necrotizing fasciitis in two patients with myelodysplastic syndrome treated with azacitidine.
abstract: Azacitidine is a novel agent for treating myelodysplastic syndromes (MDS). It has a relatively safe toxicity profile with very few reported skin toxicities. Patients with MDS were prone to get severe infections, especially via respiratory tract, urinary system, and bloodstream. However, necrotizing fasciitis (NF) is a relatively rare event in patients with MDS, and it is hard to diagnose early. Here, we report two MDS cases that developed NF in lower extremities while receiving azacitidine treatment. One of them survives after emergent fasciotomy along with the administration of broad-spectrum antibiotics and intravenous immunoglobulin.
authors.affiliation: Division of Hematology and Oncology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Shiue-Wei
authors.initials: SW
authors.lastname: Lai
authors.forename: Tzu-Chuan
authors.initials: TC
authors.lastname: Huang
authors.forename: Ren-Hua
authors.initials: RH
authors.lastname: Ye
authors.forename: Yi-Ying
authors.initials: YY
authors.lastname: Wu
mesh_terms: D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage / Q000009:adverse effects*; D001374:Azacitidine / Q000008:administration & dosage / Q000009:adverse effects*; D019115:Fasciitis, Necrotizing / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D007710:Klebsiella Infections / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D007711:Klebsiella pneumoniae / Q000302:isolation & purification; D007866:Leg / Q000382:microbiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000188:drug therapy* / Q000473:pathology
chemical_list: D000900:Anti-Bacterial Agents; D000964:Antimetabolites, Antineoplastic; D016756:Immunoglobulins, Intravenous; D001374:Azacitidine
keywords: azacitidine; myelodysplastic syndrome; necrotizing fasciitis