Fulminant Necrotizing Fasciitis Caused by Aeromonas sobria in Neutropenic Patients

Abstract

Infection with Aeromonas species has been reported to occur in neutropenic patients. Necrotizing fasciitis caused by Aeromonas species is uncommon but potentially life-threatening. We herein describe three cases of fulminant necrotizing fasciitis caused by Aeromonas sobria in neutropenic patients. These cases shared many clinical characteristics, including shock, coagulopathy, multiple organ failure and rapidly deteriorating and eventually fatal clinical courses. In all cases, Aeromonas sobria was resistant to most antibiotics, except quinolones. Our experience suggests that necrotizing fasciitis caused by Aeromonas sobria is a distinctive and fatal entity. As the use of quinolones is not usually considered in cases of febrile neutropenia, it is important to adjust the antibiotics in time when culture results become available. In some cases, early treatment with quinolones and surgical intervention should be considered, especially when this complication occurs in patients with profound neutropenia.