1998 Volume 31 Issue 10 Pages 1343-1346
We report a patient with necrotizing fasciitis caused by severe streptococcal infection. The patient was rescued by debridement and on-line continuous hemodiafiltration (CHDF). A 39-year-old male was hospitalized with a complaint of pain in the left thigh and high fever. Sepsis and hypotension subsequently developed, and we diagnosed severe infection due to group A streptococcus. We initiated antibiotic therapy, debridement of the left thigh, and on-line CHDF. The patient recovered gradually, and we stopped on-line CHDF and started intermittent hemodialysis (HD) on the 9th day of illness. Urine volume increased starting the 22nd day of illness, and HD was discontinued on day 30. Mesh skin graft surgery was performed on day 86 of illness. The patient is now in good condition. We consider that antibiotic therapy and debridement are effective, and that on-line CHDF is useful for control of fluid, electrolytes, and acid-base balance. These therapies undoubtedly contributed to the rescue of this patient.
