Necrotizing Fasciitis: Expect the unexpected

• Published in: International journal of surgery case reports Vol. 76; pp. 199 - 201
• Main Authors: Khalid, Maha, Dattani, Mit, Bowley, Douglas
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.01.2020; Elsevier
• Subjects: Case Report; Debridement; Necrotizing Fasciitis; Salmonella Newport; Necrotizing Fasciitis; Debridement; Case report; Salmonella Newport
• ISSN: 2210-2612; 2210-2612
• DOI: 10.1016/j.ijscr.2020.09.132

•Necrotizing Fasciitis is a rapidly progressive and potentially lethal soft tissue infection, aggressive surgical debridement supplemented with culture sensitive antibiotics is essential.•Skin and soft tissue infections due to non-typhoidal salmonella present as subcutaneous abscesses in the vicinity of the G.I tract or as a wound infection post-surgery on a contaminated organ.•Salmonella Newport has recently been implicated in diarrheal illness in humans specially in those consuming minced beef in the US.•Necrotizing Fasciitis due to Salmonella, has been reported with group B and C however no previous reports of human NF have been reported with this serovars. Necrotizing fasciitis is a rapidly progressive and potentially fatal soft tissue infection. A wide spectrum of aerobic and nonaerobic organisms has been implicated as the causative pathogen. Necrotizing Fasciitis due to Salmonella serovars have previously been implicated both with and without a prodromal diarrheal illness, but mono-microbial Salmonella NF is very rare. We have discussed the case of a 67-year-old man who presented with necrotizing fasciitis of the perianal region in the emergency department of our hospital. He underwent serial debridement and a defunctioning colostomy, tissue and blood cultures revealed Salmonella Newport as the culprit microorganism. He received antibiotic therapy tailored to the organism and was discharged on recovery. He currently awaits a reversal of his colostomy. Necrotizing fasciitis infections are rapidly progressive and potentially lethal, a high index of suspicion and aggressive surgical debridement supplemented with culture sensitive antibiotics is essential. Salmonella Newport has recently been implicated in diarrheal illness, associated with consumption of minced beef in the US. To the best of our knowledge, no previous reports of NF have been published related to Salmonella newport. The unexpected growth of this organism from tissue cultures and the excellent response to treatment prompted us to highlight this case as the first report of its type in the medical literature. Necrotizing soft tissue infections are associated with considerable morbidity and mortality, and delayed recognition and treatment can have severe implications. Necrotizing fasciitis due to Salmonella serovars has been reported with Group B and C however no previous reports of NF have been reported with this serovar.