A fatal case of community-acquired Acinetobacter pittii necrotising fasciitis, and a review of the literature

Abstract

We report a fatal case of a comorbid male in his 70s admitted for erysipelas on the right lower leg. The condition developed rapidly and during debridement, the patient was diagnosed with necrotising fasciitis (NF). A. pittii was isolated from both blood and tissue samples. Despite broad-spectrum antibiotics, hyperbaric oxygen treatment and surgical intervention, the patient died from multiple organ failure. A review was conducted with a PubMed search for case reports/cohort studies with cases of Acinetobacter NF. Twenty-three articles were identified reporting on 30 cases with NF caused by Acinetobacter sp. (Acinetobacter baumanii 83 %, A. pittii 0). Infections were polymicrobial in 57 % of cases and fatal in 47 % of cases. For cases unrelated to war, most identified patients suffered from one or more comorbidities. A. pittii should be considered an important finding in a patient with a soft skin infection, and the risk of NF should be assessed.