Aeromonas hydrophila induced necrotizing fasciitis following laparoscopic cholecystectomy | [Journal of Pakistan Medical Association • 2024]

Author(s):

1. Taimoor Khalid Janjua: Department of General Surgery, Liaquat National Hospital and Medical College, Karachi, Pakistan.

2. Saba Siddique: Department of General Surgery, Liaquat National Hospital and Medical College, Karachi, Pakistan.

3. Mohammad Faisal Ibrahim: Department of General Surgery, Liaquat National Hospital and Medical College, Karachi, Pakistan.

4. Muhammad Nadeem Khurshaidi: Department of General Surgery, Liaquat National Hospital and Medical College, Karachi, Pakistan.

Abstract:

Necrotizing fasciitis [NF] is a multifaceted disease of the muscle fascia and body tissues which demands the earliest intervention. Past reviews have documented very few cases of Aeromonas Hydrophila [AH] induced NF following abdominal surgery. AH can cause fatal NF as seen in a 72 year old female patient reported at Liaquat National Hospital &Medical College; a tertiary care center in Karachi, Pakistan on 2nd April, 2022. She had a known comorbidity of hypertension and presented with the chief complaint of symptomatic gallstones for which she underwent Laparoscopic Cholecystectomy (LAPCHOL). She developed NF of the lower abdomen post-operatively. Following uneventful Laparoscopic Cholecystectomy our patient presented to the ER two days later with severe lower abdominal pain and overlying cellulitis. Fasciotomy revealed extensive myonecrosis with necrotizing soft tissue infection. Despite undergoing extensive surgical debridement and broad spectrum antibiotic administration; the patient died in the ICU on the ffith postoperative day following septic complications. Histopathological analysis, confirmed inflammation and necrosis. Culture sensitivity of the debrided tissue revealed AH. Approach should lie towards analyzing the behaviour of such microbes in high risk patients through collective case studies. This is the first clinical case showcasing such parameters encountered in the General Surgery Department.

Page(s): 576-579

DOI: 10.1089/sur.2021.337

Published: Journal: Journal of Pakistan Medical Association, Volume: 74, Issue: 3, Year: 2024

Keywords:

Laparoscopic cholecystectomy , Necrotizing fasciitis , Aeromonas hydrophila , Myonecrosis

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