title: Excessive pediatric fasciitis necrotisans due to Pseudomonas aeruginosa infection successfully treated with negative pressure wound therapy.
abstract: The case of a 10-year old female child is described with a history of myeloproliferative disorder having skin, bone and visceral involvement. Bone marrow biopsy revealed histiocytosis X. During chemotherapy necrotizing fasciitis of the lower abdominal wall was diagnosed. Multiple microbiological cultures taken from the wound base revealed Pseudomonas aeruginosa infection. Surgical necrectomy and application of negative pressure wound therapy (NPWT) was started together with intensive care treatment for sepsis. As both wound and general condition of the patient improved, autologous split thickness skin grafting was carried out in two sitting under continuing NPWT application. The applied skin grafts showed excellent take, the perilesional subcutaneous recesses resolved and complete healing was achieved after 28 days of NPWT treatment. Proper dermatological diagnosis and immediate escharectomy complemented with application of NPWT can be life-saving in the treatment of necrotizing fasciitis.
authors.affiliation: University of Debrecen Clinical Center, Institute of Pediatrics, Debrecen, Hungary.
authors.forename: Levente
authors.initials: L
authors.lastname: Szabó
authors.affiliation: University of Debrecen Clinical Center, Institute of Pediatrics, Debrecen, Hungary.
authors.forename: István
authors.initials: I
authors.lastname: Szegedi
authors.affiliation: University of Debrecen Clinical Center, Institute of Pediatrics, Debrecen, Hungary.
authors.forename: Csongor
authors.initials: C
authors.lastname: Kiss
authors.affiliation: University of Debrecen Clinical Center, Institute of Pediatrics, Debrecen, Hungary.
authors.forename: Edit
authors.initials: E
authors.lastname: Szikszay
authors.affiliation: University of Debrecen Clinical Center, Dept. Dermatology, Burn and Dermatosurgery Unit, Debrecen, Hungary.
authors.forename: Éva
authors.initials: É
authors.lastname: Remenyik
authors.affiliation: University of Debrecen Clinical Center, Institute of Pediatrics, Debrecen, Hungary.
authors.forename: István
authors.initials: I
authors.lastname: Csízy
authors.affiliation: University of Debrecen Clinical Center, Dept. Dermatology, Burn and Dermatosurgery Unit, Debrecen, Hungary.|University of Debrecen, Faculty of Dental Medicine, Dept. of Surgery and Operative Techniques, Debrecen, Hungary.
authors.forename: István
authors.initials: I
authors.lastname: Juhász
mesh_terms: D034861:Abdominal Wall / Q000382:microbiology; D002648:Child; D019115:Fasciitis, Necrotizing / Q000382:microbiology / Q000473:pathology / Q000628:therapy*; D005260:Female; D006801:Humans; D054843:Negative-Pressure Wound Therapy / Q000379:methods*; D011552:Pseudomonas Infections / Q000382:microbiology / Q000473:pathology / Q000628:therapy*; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification*; D016038:Skin Transplantation / Q000379:methods
keywords: Pseudomonas aeruginosa infection; fasciitis necrotisans; histiocytosis X; life-saving; negative pressure wound therapy; pediatric case