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

Crit Care Med. 2004 Jan;32(1):278-81. doi: 10.1097/01.CCM.0000104920.01254.82.

Abstract

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.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Combined Modality Therapy
  • Critical Illness
  • Debridement / methods
  • Disease Progression
  • Drug Therapy, Combination
  • Fasciitis, Necrotizing / diagnosis*
  • Fasciitis, Necrotizing / therapy*
  • Fatal Outcome
  • Humans
  • Intensive Care Units
  • Male
  • New England
  • Photobacterium / isolation & purification
  • Respiration, Artificial
  • Risk Assessment
  • Severity of Illness Index
  • Shock, Septic / diagnosis
  • Shock, Septic / therapy*
  • Vibrio / isolation & purification*
  • Vibrio Infections / diagnosis
  • Vibrio Infections / therapy*