Necrotizing Fasciitis in a Patient with Minimal Change Disease
sJyun-Jie Cai, Chia-Chu Chang and Chirn-Bin Chang*
Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan
- *Corresponding Author:
- Chirn-Bin Chang, MD
No135, Nan-Shiao Street
Changhua City, 500, Taiwan
Tel: 886-4-7238595 ext.1031
E-mail: [email protected]
Received Date: May 16, 2011; Accepted Date: September 22, 2012; Published Date: September 27, 2012
Citation: Cai JJ, Chang CC, Chang CB (2012) Necrotizing Fasciitis in a Patient with Minimal Change Disease. J Nephrol Therapeut 2:126. doi:10.4172/2161-0959.1000126
Copyright: © 2012 Cai JJ, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Nephrotic syndrome complicated by necrotizing fasciitis is rare. Necrotizing fasciitis is a skin and soft tissue infection with a rapid progression and difficult diagnosis. Moreover, the early presentation of necrotizing fasciitis is similar to that of cellulitis. Serratia marcescens is a rare pathogenic cause of necrotizing fasciitis, even in skin and soft tissue infection. We present a patient with nephrotic syndrome complicated by necrotizing fasciitis caused by Serratia marcescens. A 49-year-old Chinese woman presented with minimal change disease and nephritic syndrome. She was admitted for pain in her right leg, for which she received cefazolin and clindamycin. However, 3 days later, a sanguineous bulla developed over her left calf, and she developed septic shock. After an emergency fasciotomy and broad-spectrum antibiotic administration, this patient died 12 h after fasciotomy. The blood culture and deep tissue culture collected during surgery both yielded Serratia marcescens. This unusual case reminds physicians that gramnegative bacilli can be pathogenic in soft tissue, especially in immunocompromised patients.