E. coli and E. faecalis: A Rare Cause of Necrotizing Fasciitis after Undergoing Liposuction

Jordan Carbono MS-IV^1, , Gerry Samantha Eichelberger MS-III¹, Aman Kataria MS-IV¹, Zachary Field MD², Benjamin Kaplan MD^{1, 2}, Federico Montalvo MD^{1, 2} and Diana Salazar MD^{1, 2}

¹Florida State University College of Medicine, Tallahassee, FL, USA

²Orlando Health Internal Medicine Residency, Orlando Regional Healthcare, Orlando, FL, U.S.A.

Cite this paper:
Jordan Carbono MS-IV, Gerry Samantha Eichelberger MS-III, Aman Kataria MS-IV, Zachary Field MD, Benjamin Kaplan MD, Federico Montalvo MD and Diana Salazar MD. E. coli and E. faecalis: A Rare Cause of Necrotizing Fasciitis after Undergoing Liposuction. American Journal of Medical Case Reports. 2020; 8(3):88-90. doi: 10.12691/ajmcr-8-3-6

Abstract

Necrotizing fasciitis is a considerably rare post-liposuction complication and E. coli and E. faecalis are exceedingly rare pathogens in a patient presenting with this life-threatening soft tissue infection. Although an uncommon liposuction complication, its prompt recognition is key, as it is a severe, insidiously advancing bacterial infection that can lead to high mortality if overlooked or misdiagnosed. A high index of clinical suspicion should prompt immediate treatment as imaging tools and lab markers can lead to rapid progression and are poorly specific for necrotizing fasciitis. We describe a case of a patient with post-liposuction necrotizing fasciitis associated with E. coli and E. faecalis, the first reported case in the literature. The patient presented with abdominal pain, fevers, and abdominal erythema with notable necrosis and bullae one day after surgery and underwent successful debridement and treatment with IV antibiotics. This case highlights a rare cause of necrotizing fasciitis and suggests the need for further study. In addition, it emphasizes the importance of cultures in necrotizing fasciitis cases and close follow-up in order to monitor bacterial organism prevalence, treatment options, and follow resistance patterns.

Keywords:
necrotizing fasciitis liposuction plastic surgery E. faecalis E. coli

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