Article Text
Summary
Methicillin-resistant Staphylococcus aureus (MRSA) necrotising fasciitis (NF) is rare and constitutes a medical and surgical emergency. We report a case of a 53-year-old man with type-2 diabetes mellitus and newly diagnosed HIV infection who presented with 1 week of progressively worsening bilateral sharp thigh pain. On presentation, he was febrile, tachycardic and had bilateral thigh erythema and mild tenderness without open wounds. He had leucocytosis, lactic acidosis and acute kidney injury. Urgent incision and drainage (I&D) was performed for suspected NF. Blood cultures and I&D were positive for MRSA. Biopsy of bilateral thighs showed NF. He was treated with wound washout and 6 weeks of intravenous antibiotics. After undergoing skin graft for wounds, he was discharged to physical rehabilitation. Here we report severe sepsis from bilateral thigh MRSA NF in a patient with newly diagnosed HIV.
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Footnotes
Contributors DC collected most of the background information, obtained patient consent, collected and analysed data, drafted and critically revised the manuscript. DC approved the final version of the manuscript for publication. AS assisted in the collection of background information, data and its analysis. AS also drafted and critically revised the manuscript. AS approved the final version of the manuscript for publication. Juan Galvis assisted in the collection of background information, data and its analysis. As also drafted and critically revised the manuscript for its medical and ethical accuracy. Approved the final version of the manuscript for publication. Juan Guardiola assisted in the collection of background information, data and its analysis. Juan Guardiola also drafted and critically revised the manuscript for its medical and ethical accuracy. Juan Guardiola approved the final version of the manuscript for publication.
Competing interests None declared.
Patient consent Obtained.
Provenance and peer review Not commissioned; externally peer reviewed.