Abstract
A 45-year-old man was urgently admitted to our hospital because of a several-week history of high fever and back swelling. During examination, the patient's consciousness was clouded, and his skin between the neck and back was red and swollen. A blood examination on admission revealed severe inflammation and abnormal blood coagulation. Computed tomography showed an increased density of the subcutaneous adipose tissue with gas extending from the neck to the back, multiple nodular shadows in both lungs, and bilateral pleural fluid retention. Because acute respiratory failure associated with septic shock was suspected, the patient was transferred to ICU. Incision of the swollen skin revealed necrosis of some fascias with a large amount of light yellow pus discharge. A culture of the pus yielded methicillin-resistant Staphylococcus aureus (MRSA). Early incision, pus drainage, debridement, and antimicrobial treatment were performed, and the patient was discharged from the hospital on the 93rd day of hospitalization.
This is the tenth case of necrotizing fasciitis triggered by MRSA infection in Japan. We report this rare case with some bibliographic considerations.
