Background: Necrotizing fasciitis in neonates is a rare and life-threatening infection involving necrosis of the skin, subcutaneous tissues, deep fascia, and sometimes underlying muscles, with a fulminant course and high mortality rate. Necrotizing fasciitis with gas gangrene related to infection of a peripherally inserted central catheter is very rare.
Case Presentation: The patient was a full-term female neonate born by vaginal delivery. Following diagnosis of patent ductus arteriosus, indomethacin was administered from a peripherally inserted central catheter for 3 days. Four days after the termination of medical treatment for the patent ductus arteriosus, the patient developed fever and a severely elevated inflammatory response was identified from blood testing. Around the right anterior chest wall, corresponding to the site of the catheter tip, redness was increased and gas crepitus was felt under the skin. Computed tomography revealed emphysema in the anterior chest, in subcutaneous areas and between muscles. Emergency surgical debridement was performed under a diagnosis of necrotizing fasciitis with gas gangrene. With antibiotic treatment, we started to fill the wound with a dialkyl carbamoyl chloride-coated dressing and povidone-iodine sugar ointment after washing with saline once a day. The patient survived and after 3 weeks of treatment with the dressing, the wound had successfully resolved without motor impairments.
Conclusions: In addition to medical treatment and prompt surgical debridement, we used dialkyl carbamoyl chloride-coated dressing and povidone-iodine sugar ointment for antiseptic dressings and successfully treated neonatal necrotizing fasciitis with gas gangrene caused by peripherally inserted central catheter infection with Citrobacter koseri.
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http://dx.doi.org/10.1186/s40792-023-01690-z | DOI Listing |
Med Klin Intensivmed Notfmed
December 2024
Department of Orthopedics and Trauma Surgery, Faculty of Medicine, Medical Center - University of Freiburg, Hugstetter Straße 55, 79106, Freiburg, Deutschland.
J Fr Ophtalmol
December 2024
Department of Ophthalmology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan.
Cureus
November 2024
Division of Orthopaedic Surgery, Tokyo Women's Medical University, Tokyo, JPN.
Few neonatal cases of soft tissue and osteoarticular infections with have been reported. We report a rare clinical presentation of necrotizing fasciitis of the foot caused by in a 17-day-old male neonate with hypoplastic left-sided heart syndrome. Fulminant progressive black skin necrosis was triggered by fresh frozen plasma leakage from the peripheral venous access.
View Article and Find Full Text PDFCureus
November 2024
Department of Anesthesia, Intensive Care, and Pain Medicine, Sant'Anna and San Sebastiano Hospital, Caserta, ITA.
Group A (GAS), particularly (), is a significant human pathogen responsible for infections often ranging from mild superficial conditions to severe, life-threatening diseases like necrotizing fasciitis (NF) and streptococcal toxic shock syndrome (STSS). This case report details the rapid deterioration of a previously healthy 49-year-old woman who presented with localized symptoms in her left thigh, later escalating to septic shock and multi-organ failure related to GAS infection. Initial evaluations indicated significant inflammation and acute kidney injury, prompting broad-spectrum antibiotic treatment.
View Article and Find Full Text PDFBMJ Case Rep
December 2024
Surgery, Shri BM Patil Medical College Hospital and Research Centre, Vijayapura, Karnataka, India.
Necrotising fasciitis (NF), commonly referred to as 'flesh-eating disease', is a rare but life-threatening infection. It rapidly affects subcutaneous tissue, leading to necrosis of the overlying skin. Though primarily seen in the abdomen, perineum and lower limbs, periorbital involvement is rare.
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