Necrotizing fasciitis in patients with liver cirrhosis: predominance of monomicrobial Gram-negative bacillary infections

Ching Chi Lee, Chih-Hsien Chi, Nan-Yao Lee, Hsin Chun Lee, Chung-Lin Chen, Po-Lin Chen, Chia-Ming Chang, Chi Jung Wu, Nai-Ying Ko, Ming Che Tsai, Wen-Chien Ko

Research output: Contribution to journalArticlepeer-review

43 Citations (Scopus)

Abstract

Necrotizing fasciitis (NF), a rare but severe infection, usually occurs in individuals with underlying chronic illness, but its clinical presentation among cirrhotic patients is infrequently discussed. Forty-two cirrhotic patients with 47 episodes of NF between 1995 and 2006 were analyzed. Their mean age was 55.6 years, with male preponderance (34 patients, 81%). Lower extremities were mainly involved (70%). Of 42 episodes with identified pathogens, 41 (97%) were monomicrobial infections and were caused mainly by Gram-negative rods (GNBs) (32, 76%), including Vibrio (15, 36%), Klebsiella (9, 21%), and Aeromonas spp. (6, 14%). As compared with NF caused by Gram-positive cocci (GPCs), NF caused by GNBs tended to have concurrent bacteremia (81% versus 50%, P = 0.09) and initially presented with septic shock (75% versus 30%, P = 0.02). However, the in-hospital mortality rate was similar for NF caused by GNBs and GPCs (34% versus 30%, P = 1.00). In multivariate analyses, higher sepsis-related organ failure assessment scores (>8) and Child-Pugh class C at initial presentation were independently associated with poor prognoses.

Original languageEnglish
Pages (from-to)219-225
Number of pages7
JournalDiagnostic Microbiology and Infectious Disease
Volume62
Issue number2
DOIs
Publication statusPublished - 2008 Oct 1

All Science Journal Classification (ASJC) codes

  • Microbiology (medical)
  • Infectious Diseases

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