부산대학교 도서관

A 41-year-old male patient was admitted to our out-patient clinic for painful swelling in his back and general poor physical condition. From a few years ago, a skin tumor diagnosed as atheroma developed on his back, but it appeared to be infected and worsening from three weeks ago. Physical examination revealed severe infection and bacteremia with sepsis. Basketball-sized swelling with redness, purpura, tenderness and snow-ball crepitation was observed the right side of his back. Blood examination revealed severe diabetes and inflammatory response. A large abscess with gas in his swollen back was noted on computed tomography. Urgent exploratory incision confirmed extensive necrosis and pus in the lesional soft tissue, which was diagnosed as necrotizing soft tissue infection. Peptoniphilus sp. was detected from the bacteriological culture. Extensive debridement was performed and negative pressure closing therapy was started from the fourth day after debridement. Wound closure was accomplished with partial stitching and split skin grafting. Gram-positive anaerobic cocci groups, such as Peptoniphilus sp., are generally considered to be hypo-virulent, slow growing, well-responsive to antimicrobial therapy, and difficult to identify. In NSTI, they are often detected in mixed infections; however, they are relatively rare in single infection. In recent years, re-examination of the phylogenetic classification has progressed, and further information as well as understanding of the pathological significance are needed.Skin Research, 17: 16-20, 2018