ABSTRACT
Necrotizing fasciitis is a rare, often fatal, soft tissue infection involving any of the layers of soft tissue. Although rare, cases continue to be reported among patients with impariments of the immune system, such as in diabetics. We present the case of a 53-year-old obese, female, diabetic patient who presented to the Emergency Department at United Hospital Center in Clarksburg with necrotizing fasciitis and was subsequently surgically treated.
Subject(s)
Diabetes Complications/microbiology , Fasciitis, Necrotizing/diagnosis , Debridement , Fasciitis, Necrotizing/etiology , Fasciitis, Necrotizing/surgery , Female , Groin/microbiology , Groin/surgery , Humans , Middle AgedABSTRACT
A 47-year-old white male came to the hospital emergency department complaining of chest pain. At admission, it was noted that the patient had numerous lesions on his buttocks, abdomen, back, and all extremities. These lesions had been there for approximately 5 months--they developed after he discontinued his cholesterol medication due to lapsed insurance coverage. He had a similar eruption when he went off cholesterol medication on another occasion. The patient's medical history included type 2 diabetes mellitus, hypertension, coronary artery disease, and hyperlipidemia. He has had multiple heart catheterizations with stent placement, most recently 2 years ago. His mother also had diabetes mellitus, and she died at age 58 from a myocardial infarction. On examination, his lesions were painless and nonpruritic. He had numerous yellow papules on his buttocks, abdomen, back, and upper and lower extremities. He had no lesions on his face. The rest of the physical exam showed no abnormal results. What is your diagnosis? What laboratory tests should be done to help make the diagnosis?
Subject(s)
Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use , Hypertriglyceridemia/complications , Hypolipidemic Agents/therapeutic use , Xanthomatosis/etiology , Diagnosis, Differential , Humans , Hypertriglyceridemia/therapy , Male , Middle Aged , Xanthomatosis/diagnosisABSTRACT
Bacillary angiomatosis, a rare and possibly fatal disease, occurs mainly in HIV-infected patients. However, it has been reported in patients with cancer and in recipients of solid organs receiving immunosuppressive drugs such as cyclosporine. This case report describes a 66-year-old man who came to dermatology practice in Clarksburg for an initial visit. He had a longstanding history of psoriasis and psoriatric arthritis treated with methotrexate. A biopsy of a skin lesion on his neck confirmed the diagnosis of bacillary angiomatosis.
