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CASE REPORT
Bilateral thigh methicillin-resistant Staphylococcus aureus necrotising fasciitis in a man with newly diagnosed Human Immunodeficiency Virus (HIV)
  1. Dhruv Chaudhary1,
  2. Amith Subhash1,
  3. Juan Galvis2,
  4. Juan Guardiola2
  1. 1University of Louisville, Louisville, Kentucky, USA
  2. 2Department of Pulmonary, Critical Care, and Sleep Disorders Medicine, University of Louisville School of Medicine, Louisville, Kentucky, USA
  1. Correspondence to Dr Dhruv Chaudhary, dhruv.chaudhary{at}louisville.edu

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.

https://doi.org/10.1136/bcr-2016-218468

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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.