We have to figure out an unknown.. Here's the case

 

Type 2 Diabetic male presents with fever, pain, necrotizing swelling over his left leg. His symptoms began about a week ago with swelling, redness of the left leg followed by a bronze discoloration of the skin and the appearance of hemorrhage bullae.

 

Pertinent Clinical Data:

Temp: 102.5 F

Physical exam - Extensive cutaneous Gangrene observed over his left leg with many ruptured bullae; black necrotic eschar with surrounding erythema.

Biopsy- areas of necrosis of the dermis and subcutaneous fat, infiltration with PMNs; vasculitis and thrombosis in vessels in the superficial fascia.

 

Specimen: Swap of Lesion exudate

 

 

 

We think it's a Group A strep mainly becuase of Gangrene and also the black eschar.. But not sure. Anyone have any ideas of the bacteria it could be? We have a list of possible ones so if you have one in mind please post! Thanks!

Edited April 9, 20178 yr by rmz1212

Sounds indeed much liek GAS. They are infamous for necrotising fasciitis. Another one that pops into mind is the C. perfringens, a gram positive anaerobic one that causes gas gangrene ...

 

Anyway ... Surgery.

Edited April 9, 20178 yr by Function

On 4/9/2017 at 11:46 AM, rmz1212 said:

We have to figure out an unknown.. Here's the case

 

Type 2 Diabetic male presents with fever, pain, necrotizing swelling over his left leg. His symptoms began about a week ago with swelling, redness of the left leg followed by a bronze discoloration of the skin and the appearance of hemorrhage bullae.

 

Pertinent Clinical Data:

Temp: 102.5 F

Physical exam - Extensive cutaneous Gangrene observed over his left leg with many ruptured bullae; black necrotic eschar with surrounding erythema.

Biopsy- areas of necrosis of the dermis and subcutaneous fat, infiltration with PMNs; vasculitis and thrombosis in vessels in the superficial fascia.

 

Specimen: Swap of Lesion exudate

 

 

 

We think it's a Group A strep mainly becuase of Gangrene and also the black eschar.. But not sure. Anyone have any ideas of the bacteria it could be? We have a list of possible ones so if you have one in mind please post! Thanks!

That sounds like Ebola Virus based on the blood vessels and hemorrhage bullae with a "fever" state, the skin matches Ebola Virus too then again if he had seen swelling a week ago with Ebola Virus he would be dead at that point so probably a bacteria. So, Function was right, but that did sound like day 9-10 symptoms of Ebola Virus. 

Edited November 27, 20178 yr by Vmedvil