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Gangrenous cellulitis caused by coagulase‑negative Staphylococcus infection: A case report

A 40-year-old male with a history of alcohol and drug addiction presented with fever for 1 day in the emergency room. He reported the abuse of drugs via intravenous injection and consumed alcohol excessively. Upon arrival to the emergency room, his body temperature was 39.4˚C. Upon a physical examin...

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Autores principales: Chen, Pang-Yen, Chen, Chien-Wei, Su, Yu-Jang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: D.A. Spandidos 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9829234/
https://www.ncbi.nlm.nih.gov/pubmed/36698910
http://dx.doi.org/10.3892/mi.2022.56
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author Chen, Pang-Yen
Chen, Chien-Wei
Su, Yu-Jang
author_facet Chen, Pang-Yen
Chen, Chien-Wei
Su, Yu-Jang
author_sort Chen, Pang-Yen
collection PubMed
description A 40-year-old male with a history of alcohol and drug addiction presented with fever for 1 day in the emergency room. He reported the abuse of drugs via intravenous injection and consumed alcohol excessively. Upon arrival to the emergency room, his body temperature was 39.4˚C. Upon a physical examination, generalized skin gangrene over the trunk and four limbs were found. Laboratory tests revealed thrombocytopenia (platelets, 67,000/µl) and elevated C-reactive protein (30.4 mg/dl), creatine kinase (>20,000 IU/l), D-Dimer (>10,000 ng/ml) levels. The urinary drug screen test was positive for ketamine and benzodiazepine. The blood culture on day 4 of admission yielded coagulase-negative Staphylococcus (CoNS). The patient was diagnosed with CoNS induced by the venous injection of ketamine. He was admitted and received treatment with parenteral antibiotics with serial debridement due to the progressive necrosis of the skin gangrene. He was discharged 2 months later with clinical improvement. CoNS generally has a symbiotic association with the hosts in the cutaneous ecosystem, which frequently contaminates blood culture and occasionally causes diseases. CoNS should be thus considered opportunistic pathogens rather than contaminants. These organisms can cause occasional infection if the cutaneous organ system has been damaged by trauma, the direct implantation of foreign bodies or inoculation by needles. Predisposing factors for CoNS infections include an older age, immunosuppression and the implantation of medical devices, which may serve as a nidus for CoNS growth. Long-term alcoholism, drug addiction and malnutrition may have caused a decline in the immunity of the patient described herein. To date, at least to the best of our knowledge, there has been no report describing local skin necrosis induced by CoNS infection. In the case in the present study, treatment with parenteral antibiotics and serial debridement was successful. In summary, physicians need to be aware of the potential pathogenicity of CoNS in the skin and soft tissue infections.
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spelling pubmed-98292342023-01-24 Gangrenous cellulitis caused by coagulase‑negative Staphylococcus infection: A case report Chen, Pang-Yen Chen, Chien-Wei Su, Yu-Jang Med Int (Lond) Case Report A 40-year-old male with a history of alcohol and drug addiction presented with fever for 1 day in the emergency room. He reported the abuse of drugs via intravenous injection and consumed alcohol excessively. Upon arrival to the emergency room, his body temperature was 39.4˚C. Upon a physical examination, generalized skin gangrene over the trunk and four limbs were found. Laboratory tests revealed thrombocytopenia (platelets, 67,000/µl) and elevated C-reactive protein (30.4 mg/dl), creatine kinase (>20,000 IU/l), D-Dimer (>10,000 ng/ml) levels. The urinary drug screen test was positive for ketamine and benzodiazepine. The blood culture on day 4 of admission yielded coagulase-negative Staphylococcus (CoNS). The patient was diagnosed with CoNS induced by the venous injection of ketamine. He was admitted and received treatment with parenteral antibiotics with serial debridement due to the progressive necrosis of the skin gangrene. He was discharged 2 months later with clinical improvement. CoNS generally has a symbiotic association with the hosts in the cutaneous ecosystem, which frequently contaminates blood culture and occasionally causes diseases. CoNS should be thus considered opportunistic pathogens rather than contaminants. These organisms can cause occasional infection if the cutaneous organ system has been damaged by trauma, the direct implantation of foreign bodies or inoculation by needles. Predisposing factors for CoNS infections include an older age, immunosuppression and the implantation of medical devices, which may serve as a nidus for CoNS growth. Long-term alcoholism, drug addiction and malnutrition may have caused a decline in the immunity of the patient described herein. To date, at least to the best of our knowledge, there has been no report describing local skin necrosis induced by CoNS infection. In the case in the present study, treatment with parenteral antibiotics and serial debridement was successful. In summary, physicians need to be aware of the potential pathogenicity of CoNS in the skin and soft tissue infections. D.A. Spandidos 2022-10-11 /pmc/articles/PMC9829234/ /pubmed/36698910 http://dx.doi.org/10.3892/mi.2022.56 Text en Copyright: © Chen et al. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License (https://creativecommons.org/licenses/by-nc-nd/4.0/) , which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
spellingShingle Case Report
Chen, Pang-Yen
Chen, Chien-Wei
Su, Yu-Jang
Gangrenous cellulitis caused by coagulase‑negative Staphylococcus infection: A case report
title Gangrenous cellulitis caused by coagulase‑negative Staphylococcus infection: A case report
title_full Gangrenous cellulitis caused by coagulase‑negative Staphylococcus infection: A case report
title_fullStr Gangrenous cellulitis caused by coagulase‑negative Staphylococcus infection: A case report
title_full_unstemmed Gangrenous cellulitis caused by coagulase‑negative Staphylococcus infection: A case report
title_short Gangrenous cellulitis caused by coagulase‑negative Staphylococcus infection: A case report
title_sort gangrenous cellulitis caused by coagulase‑negative staphylococcus infection: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9829234/
https://www.ncbi.nlm.nih.gov/pubmed/36698910
http://dx.doi.org/10.3892/mi.2022.56
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