Saijo Masaji, Constantine Shadia, Wakai Toshiaki, Wada Naoki, Narita Mitsuo
Primary Center, Sapporo Tokushukai Hospital, Sapporo, JPN.
Family Medicine, University of Michigan, Ann Arbor, USA.
Cureus. 2025 Jun 13;17(6):e85951. doi: 10.7759/cureus.85951. eCollection 2025 Jun.
(), a Gram-positive, anaerobic, rod-shaped bacterium, is typically associated with pharyngitis and skin infections but can also cause severe, life-threatening infections such as sepsis and necrotizing fasciitis (NF), particularly in immunocompromised patients. We report a case of severe NF of the lower extremity caused by a mixed infection with and () in a patient with diabetes mellitus. A 51-year-old male with poorly controlled diabetes mellitus presented with extensive swelling, necrosis, and bullae formation in his left lower extremity five days after sustaining a puncture wound. Laboratory tests revealed elevated creatine kinase and inflammatory markers, and imaging identified subcutaneous gas. The patient was diagnosed with NF and underwent emergent debridement. Blood and intraoperative tissue cultures grew both and . Despite aggressive surgical management and appropriate antibiotic therapy, the infection progressed, and the patient underwent a below-ankle amputation on hospital day seven and a below-knee amputation on hospital day 29. Antimicrobial therapy was concluded on day 32. This case underscores the potential for , particularly in combination with other pathogens such as , to cause rapidly progressing and life-threatening NF, particularly in patients with underlying risk factors such as poorly controlled diabetes mellitus.
（）是一种革兰氏阳性厌氧杆菌，通常与咽炎和皮肤感染有关，但也可引起严重的、危及生命的感染，如败血症和坏死性筋膜炎（NF），尤其是在免疫功能低下的患者中。我们报告一例糖尿病患者因（）与（）混合感染导致下肢严重坏死性筋膜炎的病例。一名51岁男性糖尿病患者，血糖控制不佳，在左下肢遭受刺伤五天后，出现广泛肿胀、坏死和大疱形成。实验室检查显示肌酸激酶和炎症标志物升高，影像学检查发现皮下气体。患者被诊断为坏死性筋膜炎并接受了紧急清创术。血液和术中组织培养均培养出（）与（）。尽管采取了积极的手术治疗和适当的抗生素治疗，感染仍进展，患者在住院第7天接受了踝关节以下截肢术，在住院第29天接受了膝关节以下截肢术。抗菌治疗在第32天结束。该病例强调了（）尤其是与其他病原体如（）联合时，导致快速进展和危及生命的坏死性筋膜炎的可能性，特别是在有潜在危险因素如血糖控制不佳的糖尿病患者中。
