Patient with liver cirrhosis presenting with necrotizing fasciitis due to Acinetobacter junii: A case report and literature review

J Infect Chemother. 2020 Feb;26(2):308-311. doi: 10.1016/j.jiac.2019.09.018. Epub 2019 Nov 1.

Abstract

Acinetobacter spp. are known to be a cause of nosocomial infections and to have diverse mechanisms of resistance to antimicrobials. Here, we report the case of a patient who presented to our emergency department with necrotizing fasciitis due to Acinetobacter junii as confirmed by Matrix-Assisted Laser Desorption/Ionization Time-of-Flight mass spectrometry (MALDI-TOF MS). Patients with liver cirrhosis are susceptible to gram-negative infection. Moreover, although Acinetobacter spp. infection is best known to be a cause of combat-related-skin and soft-tissue infections, we propose that medical professionals need to consider the presence of these potentially multi-drug-resistant, gram-negative pathogens when treating patients with liver cirrhosis who present with severe soft-tissue infections. To our knowledge, this is the first case report of severe-skin and soft-tissue infections caused by A. junii.

Keywords: Acinetobacter species; Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS); Necrotizing fasciitis.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Acinetobacter / isolation & purification*
  • Acinetobacter Infections / complications
  • Acinetobacter Infections / diagnosis*
  • Acinetobacter Infections / drug therapy
  • Acinetobacter Infections / microbiology
  • Aged
  • Anti-Bacterial Agents / therapeutic use
  • Community-Acquired Infections / diagnosis
  • Community-Acquired Infections / drug therapy
  • Community-Acquired Infections / microbiology
  • Fasciitis, Necrotizing / complications
  • Fasciitis, Necrotizing / diagnosis*
  • Fasciitis, Necrotizing / drug therapy
  • Fasciitis, Necrotizing / microbiology*
  • Humans
  • Leg / pathology
  • Liver Cirrhosis / complications*
  • Male
  • Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization / methods
  • Treatment Outcome
  • Wounds and Injuries / microbiology

Substances

  • Anti-Bacterial Agents

Supplementary concepts

  • Acinetobacter junii