2007 Volume 117 Issue 9 Pages 1439-1443
A 71-year-old Japanese woman with ill-controlled diabetes and hypertention noted tingling pain in the left genital skin after scratching, followed 2 weeks later by tenderness of the left lower abdomen with general fatigue. The patient consulted our hospital, since a prior treatment with antibiotics failed to mitigate the aggravation of her symptoms, skin lesion, or laboratory data including marked leukocytosis and increasing CRP. During her hospitalization, we performed debridment under general anesthesia twice as well as drainage three times, This revealed subcutaneous tunnels of 2–4cm in diameter anastomosing throughout the abdominal superficial fascia. The walls of the tunnels were demarcated by thick fibrous tissue and filled with necrotic material from which Peptostreptococcus micros was cultured. Clinical examinations disclosed an early stage carcinoma of her stomach that was excised curatively in the same admission period of 37 days.