Lab question

[rmz1212]

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, 2017 by rmz1212

[Function]

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, 2017 by Function

[Vmedvil]

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, 2017 by Vmedvil