Rapidly advancing necrotizing fasciitis caused by Photobacterium (Vibrio) damsela: a hyperaggressive variant.

Objective: To describe the first case of Vibrio damsela necrotizing fasciitis in New England, emphasizing the importance of very early operative intervention to achieve source control in this extremely aggressive infection.

Design: Case report.

Setting: Surgical intensive care unit at Tufts-New England Medical Center in Boston, MA.

Patient: A 69-yr-old retired fisherman with rapidly progressive necrotizing fasciitis from Photobacterium (Vibrio) damsela infection and ensuing multiple-system organ failure.

Interventions: Surgical debridement, ventilator support, vasopressors, continuous veno-venous hemofiltration, and blood product transfusions.

Measurements And Main Results: Death.

Conclusions: A high index of suspicion is necessary for the diagnosis of this specific pathogen and concordant infection. The willingness to surgically debride and amputate without hesitation at a very early point may be the only intervention capable of saving the lives of patients affected by Photobacterium (Vibrio) damsela.