A case report of Actinomyces-associated vulvar necrotizing soft tissue infection: Aspects of multidisciplinary care
International Journal of Surgery Case Reports
Introduction and importance: Necrotizing soft-tissue infections are life-threatening infections with significant morbidity and mortality.
Case presentation: A 36-year-old female gravida 1 para 1001 with a history of intravenous drug use and homelessness presented to the emergency department for a three-day history of labial pain, swelling, and fevers. A contrast tomography scan revealed necrotizing soft tissue infection of the mons and vulva with subcutaneous gas. Empiric broad-spectrum antibiotics were initiated. She underwent an emergent two-staged surgical debridement and delayed primary closure after 1-month in the hospital. She was discharged to complete a 9 to 12 month course of antibiotics. Multidisciplinary team was central to patient care.
Clinical discussion: Necrotizing soft tissue infections are a diverse group of infections affecting the subcutaneous tissue, muscle, and fascia. Actinomyces is a rare cause and require long-term antibiotics. Early recognition and emergent surgical debridement has been shown to reduce morbidity and mortality. A multidisciplinary approach is critical for proper wound care and healing, pain management, and long-term follow up.
Conclusions: Actinomyces-associated vulvar NSTIs are life-threatening infections requiring early surgical debridement, long-term antibiotics, and multidisciplinary approach.
Lee, B., & Mroz, P. (2022). A case report of Actinomyces-associated vulvar necrotizing soft tissue infection: Aspects of multidisciplinary care. International Journal of Surgery Case Reports, 96, 107314. https://doi.org/10.1016/j.ijscr.2022.107314