Abstract
Necrotic fascitis by Aeromonas hydrophila is quite rare. We report a severe case of this complication after surgery for gastric malignancy. A 74-year-old woman with malignant lymphoma of the whole stomach under-went total gastrectomy. Postoperatively, she showed septic symptoms by the evening of the day of operation. By the next day, subcutaneous hemorrhage had appeared in her abdominal wall, and necrotic fascitis devel-oped several hours afterward. Necrotic skin and subcutaneous tissues were aggressively excised and antibi-otic therapy changed to cover all suspected bacteria. Gram-negative bacillus was noted in smear Gram stain- ing incised necrotic tissue, ascites, and blood. The patient died about 50 hours after operation, despite at-tempts at resuscitation. The colonization of Aeromonas hydrophila was obtained some days later. To our knowl-edge, this is the first case reported of postoperative necrotic fascitis and sepsis by Aeromonas hydrophila. We suggest that since infection by Aeromonas hydrophila can be very serious for the compromised host, prophylac-tic antibiotics covering Gramnegative bacillus should be used for such patients.
