Spontaneous Necrotizing Soft Tissue Infection and Fatal Clostridium septicum Septicemia in Myelodysplastic Syndrome: A Case Report and Comprehensive Literature Review.

Necrotizing soft tissue infection (NSTI) is a rare but life-threatening disease characterized by rapid spread and necrosis of the skin, subcutaneous tissue, fascia, and muscle. We present a fatal case of atraumatic NSTI involving the left lower extremity in an 80-year-old female with advanced myelodysplastic syndrome. Blood cultures grew Clostridium septicum and Staphylococcus epidermidis, the latter thought to be a blood contaminant. The patient rapidly progressed to septic shock and died within 34 hours of presentation. Our case emphasizes the need for a high index of suspicion for NSTI in patients with advanced malignancies.