A rare case of necrotizing fasciitis of the leg in an intravenous drug user caused by Prevotella denticola
Background Intravenous drug users (IDUs) have a high risk of developing skin and soft tissue infections such as erysipelas, abscesses, and less frequently necrotizing fasciitis (NF) or gas gangrene. Rarely, the cause of the infection is microorganisms residing in the oral cavity and can lead to life...
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Taylor & Francis Group
2024-12-01
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| Series: | Journal of Oral Microbiology |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/20002297.2024.2334545 |
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| author | Andrea Bedini Filippo Medioli Altea Gallerani Irene Venturelli Giacomo Franceschi Marianna Meschiari Erica Franceschini Giacomo Maria Lima Mario Sarti Cristina Mussini |
| author_facet | Andrea Bedini Filippo Medioli Altea Gallerani Irene Venturelli Giacomo Franceschi Marianna Meschiari Erica Franceschini Giacomo Maria Lima Mario Sarti Cristina Mussini |
| author_sort | Andrea Bedini |
| collection | DOAJ |
| description | Background Intravenous drug users (IDUs) have a high risk of developing skin and soft tissue infections such as erysipelas, abscesses, and less frequently necrotizing fasciitis (NF) or gas gangrene. Rarely, the cause of the infection is microorganisms residing in the oral cavity and can lead to life-threatening infections.Methods We describe the case of a 43-year-old man intravenous drug user (IDU) who was admitted for intense leg pain following an injection of cocaine at that site.Results A clinical and radiological diagnosis of NF was made, so the patient was started on empirical antibiotic therapy and underwent surgical fasciotomy (after 8 hours from admission). Prevotella denticola was isolated from multiple intraoperative specimens and was resistant to initial antimicrobial therapy. The man, suffering from periodontal disease, reported sucking the syringe several times to unblock it. Both fasciotomy surgery and adjustment of antimicrobial therapy enabled therapeutic success.Conclusions In IDUs the risk of deep skin and soft tissue infections is high and may be aggravated by contamination with oral microorganisms. The choice of empirical antibiotic treatment should include agents active against oral cavity anaerobes, such as P. denticola. |
| format | Article |
| id | doaj-art-0be036fe3ed54584a08d3498e08de057 |
| institution | DOAJ |
| issn | 2000-2297 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Journal of Oral Microbiology |
| spelling | doaj-art-0be036fe3ed54584a08d3498e08de0572025-08-20T02:48:11ZengTaylor & Francis GroupJournal of Oral Microbiology2000-22972024-12-0116110.1080/20002297.2024.2334545A rare case of necrotizing fasciitis of the leg in an intravenous drug user caused by Prevotella denticolaAndrea Bedini0Filippo Medioli1Altea Gallerani2Irene Venturelli3Giacomo Franceschi4Marianna Meschiari5Erica Franceschini6Giacomo Maria Lima7Mario Sarti8Cristina Mussini9Infectious Diseases Unit, Azienda Ospedaliero-Universitaria Policlinico di Modena, Modena, ItalyInfectious Diseases Unit, Azienda Ospedaliero-Universitaria Policlinico di Modena, Modena, ItalyInfectious Diseases Unit, Azienda Ospedaliero-Universitaria Policlinico di Modena, Modena, ItalyClinical Microbiology Unit, Azienda Ospedaliero-Universitaria Policlinico di Modena, Modena, ItalyInfectious Diseases Unit, Azienda Ospedaliero-Universitaria Policlinico di Modena, Modena, ItalyInfectious Diseases Unit, Azienda Ospedaliero-Universitaria Policlinico di Modena, Modena, ItalyInfectious Diseases Unit, Azienda Ospedaliero-Universitaria Policlinico di Modena, Modena, ItalyNuclear Medicine Unit, Azienda Ospedaliero-Universitaria Policlinico di Modena, Modena, ItalyClinical Microbiology Unit, Azienda Ospedaliero-Universitaria Policlinico di Modena, Modena, ItalyInfectious Diseases Unit, Azienda Ospedaliero-Universitaria Policlinico di Modena, Modena, ItalyBackground Intravenous drug users (IDUs) have a high risk of developing skin and soft tissue infections such as erysipelas, abscesses, and less frequently necrotizing fasciitis (NF) or gas gangrene. Rarely, the cause of the infection is microorganisms residing in the oral cavity and can lead to life-threatening infections.Methods We describe the case of a 43-year-old man intravenous drug user (IDU) who was admitted for intense leg pain following an injection of cocaine at that site.Results A clinical and radiological diagnosis of NF was made, so the patient was started on empirical antibiotic therapy and underwent surgical fasciotomy (after 8 hours from admission). Prevotella denticola was isolated from multiple intraoperative specimens and was resistant to initial antimicrobial therapy. The man, suffering from periodontal disease, reported sucking the syringe several times to unblock it. Both fasciotomy surgery and adjustment of antimicrobial therapy enabled therapeutic success.Conclusions In IDUs the risk of deep skin and soft tissue infections is high and may be aggravated by contamination with oral microorganisms. The choice of empirical antibiotic treatment should include agents active against oral cavity anaerobes, such as P. denticola.https://www.tandfonline.com/doi/10.1080/20002297.2024.2334545ABSSSIsanaerobesLRINEC Scoreintravenous drug userskin infectionsabscesses |
| spellingShingle | Andrea Bedini Filippo Medioli Altea Gallerani Irene Venturelli Giacomo Franceschi Marianna Meschiari Erica Franceschini Giacomo Maria Lima Mario Sarti Cristina Mussini A rare case of necrotizing fasciitis of the leg in an intravenous drug user caused by Prevotella denticola Journal of Oral Microbiology ABSSSIs anaerobes LRINEC Score intravenous drug user skin infections abscesses |
| title | A rare case of necrotizing fasciitis of the leg in an intravenous drug user caused by Prevotella denticola |
| title_full | A rare case of necrotizing fasciitis of the leg in an intravenous drug user caused by Prevotella denticola |
| title_fullStr | A rare case of necrotizing fasciitis of the leg in an intravenous drug user caused by Prevotella denticola |
| title_full_unstemmed | A rare case of necrotizing fasciitis of the leg in an intravenous drug user caused by Prevotella denticola |
| title_short | A rare case of necrotizing fasciitis of the leg in an intravenous drug user caused by Prevotella denticola |
| title_sort | rare case of necrotizing fasciitis of the leg in an intravenous drug user caused by prevotella denticola |
| topic | ABSSSIs anaerobes LRINEC Score intravenous drug user skin infections abscesses |
| url | https://www.tandfonline.com/doi/10.1080/20002297.2024.2334545 |
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