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@article{1782966,
author = {Lipový, Břetislav and Mager, Radomír and Raška, Filip and Hanslianova, Marketa and Blazek, Josef and Kremeckova, Hana and Suchánek, Ivan and Hladík, Martin},
article_location = {THOUSAND OAKS},
article_number = {1},
doi = {http://dx.doi.org/10.1177/15347346211004305},
keywords = {Vibrio vulnificus; skin and soft tissue infection; necrotizing fasciitis; multidrug-resistant bacteria; chemical necrectomy},
language = {eng},
issn = {1534-7346},
journal = {INTERNATIONAL JOURNAL OF LOWER EXTREMITY WOUNDS},
title = {Vibrio vulnificus-Induced Necrotizing Fasciitis Complicated by Multidrug-Resistant Acinetobacter baumannii Infection: Efficacy of Chemical Necrectomy Using 40% Benzoic Acid},
url = {https://journals.sagepub.com/doi/10.1177/15347346211004305},
volume = {22},
year = {2023}
}
TY - JOUR
ID - 1782966
AU - Lipový, Břetislav - Mager, Radomír - Raška, Filip - Hanslianova, Marketa - Blazek, Josef - Kremeckova, Hana - Suchánek, Ivan - Hladík, Martin
PY - 2023
TI - Vibrio vulnificus-Induced Necrotizing Fasciitis Complicated by Multidrug-Resistant Acinetobacter baumannii Infection: Efficacy of Chemical Necrectomy Using 40% Benzoic Acid
JF - INTERNATIONAL JOURNAL OF LOWER EXTREMITY WOUNDS
VL - 22
IS - 1
SP - 200-207
EP - 200-207
PB - SAGE PUBLICATIONS INC
SN - 15347346
KW - Vibrio vulnificus
KW - skin and soft tissue infection
KW - necrotizing fasciitis
KW - multidrug-resistant bacteria
KW - chemical necrectomy
UR - https://journals.sagepub.com/doi/10.1177/15347346211004305
N2 - Necrotizing fasciitis is a life-threatening skin and soft tissue infection associated with high morbidity and mortality in adult patients. This infection can present as either type 1 infection caused by a mixed microflora (Streptococci, Enterobacteriacae, Bacteroides sp., and Peptostreptococcus sp.), most commonly developing in patients after surgery or in diabetic patients, or as type 2. The latter type is monomicrobial and, usually, caused by group A Streptococci. Rarely, this type can be also caused by other pathogens, such as Vibrio vulnificus. V vulnificus is a small mobile Gram-negative rod capable of causing 3 types of infections in humans-gastroenteritis, primary infection of the vascular bed, and wound infections. If infecting a wound, V vulnificus can cause a life-threatening condition-necrotizing fasciitis. We present a rare case of necrotizing fasciitis developing after an insect bite followed by exposure to the seawater. Rapid propagation of the infectious complication in the region of the right lower limb led to a serious consideration of the necessity of amputation. Due to the clearly demarcated necroses and secondary skin and soft tissue infection caused by a multiresistant strain of Acinetobacter baumannii, we, however, resorted to the use of selective chemical necrectomy using 40% benzoic acid-a unique application in this kind of condition. The chemical necrectomy was successful, relatively gentle and thanks to its selectivity, vital parts of the limb remained preserved and could have been subsequently salvaged at minimum blood loss. Moreover, the antimicrobial effect of benzoic acid led to rapid decolonization of the necrosis and wound bed preparation, which allowed us to perform defect closure using split-thickness skin grafts. The patient subsequently healed without further complications and returned to normal life.
ER -
LIPOVÝ, Břetislav, Radomír MAGER, Filip RAŠKA, Marketa HANSLIANOVA, Josef BLAZEK, Hana KREMECKOVA, Ivan SUCHÁNEK and Martin HLADÍK. Vibrio vulnificus-Induced Necrotizing Fasciitis Complicated by Multidrug-Resistant Acinetobacter baumannii Infection: Efficacy of Chemical Necrectomy Using 40\%{} Benzoic Acid. \textit{INTERNATIONAL JOURNAL OF LOWER EXTREMITY WOUNDS}. THOUSAND OAKS: SAGE PUBLICATIONS INC, 2023, vol.~22, No~1, p.~200-207. ISSN~1534-7346. Available from: https://dx.doi.org/10.1177/15347346211004305.
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