• Critical care medicine · Jan 2004

    Case Reports

    Rapidly advancing necrotizing fasciitis caused by Photobacterium (Vibrio) damsela: a hyperaggressive variant.

    • Kristen H Goodell, Michael R Jordan, Roger Graham, Charles Cassidy, and Stanley A Nasraway.
    • Department of Surgery, Tufts-New England Medical Center, Tufts University School of Medicine, Boston, MA, USA.
    • Crit. Care Med. 2004 Jan 1; 32 (1): 278-81.

    ObjectiveTo describe the first case of Vibrio damsela necrotizing fasciitis in New England, emphasizing the importance of very early operative intervention to achieve source control in this extremely aggressive infection.DesignCase report.SettingSurgical intensive care unit at Tufts-New England Medical Center in Boston, MA.PatientA 69-yr-old retired fisherman with rapidly progressive necrotizing fasciitis from Photobacterium (Vibrio) damsela infection and ensuing multiple-system organ failure.InterventionsSurgical debridement, ventilator support, vasopressors, continuous veno-venous hemofiltration, and blood product transfusions.Measurements And Main ResultsDeath.ConclusionsA high index of suspicion is necessary for the diagnosis of this specific pathogen and concordant infection. The willingness to surgically debride and amputate without hesitation at a very early point may be the only intervention capable of saving the lives of patients affected by Photobacterium (Vibrio) damsela.

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