Shewanella algae Necrotizing Fasciitis and Septic Shock after Elective Cosmetic Surgery: A Potential Emerging Infection.
Eryn Percenti, Rebecca Nowacki, Adam Fennell et al.
✦ AI-curated · Sources linked
Case in brief
A previously healthy young woman developed fever and weakness four days after elective plastic surgery. Violaceous bullae extended from both breasts to the right thigh, involving surgical sites. She became hemodynamically unstable despite initial linezolid and meropenem, requiring intubation and vasopressors. Necrotizing fasciitis was diagnosed and treated with emergent debridement. Blood cultures grew Shewanella algae; operative cultures also grew Pseudomonas aeruginosa and Candida parapsilosis. After 11 further wound debridements and antimicrobial adjustment, the infection resolved, but multiple deformities remained.
What made this case unusual
S. algae infection is usually described with seawater exposure or immunocompromise; this patient was previously healthy, had no stated exposure, and developed severe infection after elective surgery. The acquisition mechanism was unclear.
Diagnostic / clinical pearl
In necrotizing wound infections after surgery, consider S. algae even when the patient is healthy and the acquisition route is unclear; culture results may identify it alongside other organisms.