A rare case of necrotizing fasciitis of the leg in an intravenous drug user caused by Prevotella denticola

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-threatenin...

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Bibliographic Details
Published in:Journal of oral microbiology 2024-12, Vol.16 (1), p.2334545
Main Authors: Bedini, Andrea, Medioli, Filippo, Gallerani, Altea, Venturelli, Irene, Franceschi, Giacomo, Meschiari, Marianna, Franceschini, Erica, Maria Lima, Giacomo, Sarti, Mario, Mussini, Cristina
Format: Article
Language:English
Subjects:
Abscesses
ABSSSIs
Anaerobes
Antibiotics
Bioaccumulation
Case Report
Cocaine
Drug abuse
Erysipelas
Gangrene
Gas gangrene
Infections
Intravenous administration
intravenous drug user
LRINEC Score
Microorganisms
Necrotizing fasciitis
Oral cavity
Periodontal disease
Periodontal diseases
Pharmacology
Prevotella
Skin diseases
skin infections
Soft tissues
Therapy
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Summary: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. 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. 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). 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. 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
ISSN:2000-2297
2000-2297
DOI:10.1080/20002297.2024.2334545