Necrotizing Fasciitis Caused by Gas-producing Methicillin-sensitive Staphylococcus aureus: A Case Report

Introduction: It is well known that diabetic patients have impaired wound healing, increased susceptibility to infection, and harbor tissue that supports the growth of gas-producing infections. Necrotizing fasciitis (NF) is an uncommon soft-tissue infection characterized by extensive necrosis of sub...

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Main Authors: Travis S. Bullock, Zachary Jodoin, Samuel S. Ornell, Nicolas A. Morton-Gonzaba, Ravi A. Karia, Case W. Martin
Format: Article
Language:English
Published: Indian Orthopaedic Research Group 2025-06-01
Series:Journal of Orthopaedic Case Reports
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Online Access:https://jocr.co.in/wp/2025/06/01/necrotizing-fasciitis-caused-by-gas-producing-methicillin-sensitive-staphylococcus-aureus-a-case-report/
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author Travis S. Bullock
Zachary Jodoin
Samuel S. Ornell
Nicolas A. Morton-Gonzaba
Ravi A. Karia
Case W. Martin
author_facet Travis S. Bullock
Zachary Jodoin
Samuel S. Ornell
Nicolas A. Morton-Gonzaba
Ravi A. Karia
Case W. Martin
author_sort Travis S. Bullock
collection DOAJ
description Introduction: It is well known that diabetic patients have impaired wound healing, increased susceptibility to infection, and harbor tissue that supports the growth of gas-producing infections. Necrotizing fasciitis (NF) is an uncommon soft-tissue infection characterized by extensive necrosis of subcutaneous tissue and fascia with relative sparing of the skin and muscle tissues. The majority of gas-producing infections are polymicrobial in nature, and therefore, NF with Staphylococcus aureus as a single etiologic agent is exceedingly uncommon. Case Report: This is a case of a 46-year-old male that developed gas-forming NF and abscesses from methicillin-sensitive S. aureus (MSSA) after a complicated course involving undiagnosed type 2 diabetes mellitus (T2DM), diabetic ketoacidosis, and bacteremia. The disease course presented relatively slowly with mild systemic symptoms, knee pain, erythema, and edema, but steadily progressed over days leading to an elevated level of care. Multidisciplinary care was necessary to treat the patient, including surgical and intravenous antibiotic therapies. The patient’s care was prolonged due to decreased patient compliance with recommended therapies and difficulty with appropriate shared decision-making. Conclusion: Although NF caused by monomicrobial infection with methicillin-resistant S. aureus has been previously reported, awareness of this condition remains limited, especially with concomitant gas formation. Physicians should have a high index of suspicion for NF with MSSA as a potential etiologic agent when treating patients with symptoms of a necrotizing soft-tissue infection, particularly those with underlying T2DM or a history of recent needle puncture. By engaging in shared decision making, health outcomes in these serious infections can be optimized.
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spelling doaj-art-eadea02325e4468aabd924c6d078cdab2025-08-20T02:10:17ZengIndian Orthopaedic Research GroupJournal of Orthopaedic Case Reports2250-06852321-38172025-06-0115619019610.13107/jocr.2025.v15.i06.5712Necrotizing Fasciitis Caused by Gas-producing Methicillin-sensitive Staphylococcus aureus: A Case ReportTravis S. BullockZachary JodoinSamuel S. OrnellNicolas A. Morton-GonzabaRavi A. KariaCase W. MartinIntroduction: It is well known that diabetic patients have impaired wound healing, increased susceptibility to infection, and harbor tissue that supports the growth of gas-producing infections. Necrotizing fasciitis (NF) is an uncommon soft-tissue infection characterized by extensive necrosis of subcutaneous tissue and fascia with relative sparing of the skin and muscle tissues. The majority of gas-producing infections are polymicrobial in nature, and therefore, NF with Staphylococcus aureus as a single etiologic agent is exceedingly uncommon. Case Report: This is a case of a 46-year-old male that developed gas-forming NF and abscesses from methicillin-sensitive S. aureus (MSSA) after a complicated course involving undiagnosed type 2 diabetes mellitus (T2DM), diabetic ketoacidosis, and bacteremia. The disease course presented relatively slowly with mild systemic symptoms, knee pain, erythema, and edema, but steadily progressed over days leading to an elevated level of care. Multidisciplinary care was necessary to treat the patient, including surgical and intravenous antibiotic therapies. The patient’s care was prolonged due to decreased patient compliance with recommended therapies and difficulty with appropriate shared decision-making. Conclusion: Although NF caused by monomicrobial infection with methicillin-resistant S. aureus has been previously reported, awareness of this condition remains limited, especially with concomitant gas formation. Physicians should have a high index of suspicion for NF with MSSA as a potential etiologic agent when treating patients with symptoms of a necrotizing soft-tissue infection, particularly those with underlying T2DM or a history of recent needle puncture. By engaging in shared decision making, health outcomes in these serious infections can be optimized.https://jocr.co.in/wp/2025/06/01/necrotizing-fasciitis-caused-by-gas-producing-methicillin-sensitive-staphylococcus-aureus-a-case-report/necrotizing soft-tissue infectionshared decision-makinginfectious diseasewound carewound vacuum-assisted closure therapy
spellingShingle Travis S. Bullock
Zachary Jodoin
Samuel S. Ornell
Nicolas A. Morton-Gonzaba
Ravi A. Karia
Case W. Martin
Necrotizing Fasciitis Caused by Gas-producing Methicillin-sensitive Staphylococcus aureus: A Case Report
Journal of Orthopaedic Case Reports
necrotizing soft-tissue infection
shared decision-making
infectious disease
wound care
wound vacuum-assisted closure therapy
title Necrotizing Fasciitis Caused by Gas-producing Methicillin-sensitive Staphylococcus aureus: A Case Report
title_full Necrotizing Fasciitis Caused by Gas-producing Methicillin-sensitive Staphylococcus aureus: A Case Report
title_fullStr Necrotizing Fasciitis Caused by Gas-producing Methicillin-sensitive Staphylococcus aureus: A Case Report
title_full_unstemmed Necrotizing Fasciitis Caused by Gas-producing Methicillin-sensitive Staphylococcus aureus: A Case Report
title_short Necrotizing Fasciitis Caused by Gas-producing Methicillin-sensitive Staphylococcus aureus: A Case Report
title_sort necrotizing fasciitis caused by gas producing methicillin sensitive staphylococcus aureus a case report
topic necrotizing soft-tissue infection
shared decision-making
infectious disease
wound care
wound vacuum-assisted closure therapy
url https://jocr.co.in/wp/2025/06/01/necrotizing-fasciitis-caused-by-gas-producing-methicillin-sensitive-staphylococcus-aureus-a-case-report/
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