Bacillus cereus Induced Necrotizing Fasciitis Mimicking Gastroenteritis: A Case Report

Abstract Necrotizing fasciitis is a rapidly spreading inflammation of the soft tissue involving the fascia and the subcutaneous tissue. Early and aggressive surgical intervention accompanied with appropriate antibiotics are the key to improve clinical outcome in patients with necrotizing fasciitis. Here, we present the case of a 46-year-old male who presented with acute onset progressive watery diarrhea and fever for one day. The abdominal ultrasound and computed tomography revealed diffuse gallbladder wall thickening with double layer sign, air density at right hepatic lobe and a small bowel edema. An intra-abdominal infection was initially suspected. However, a progressive erythematous change and bullae was found on the left thigh and lower abdomen. Progressed necrotizing fasciitis was suspected. After administration of broad antibiotics and emergency surgical intervention, the septic shock was reversed. Finally, the blood and wound culture reports revealed Bacillus cereus growth. This paper describes the clinical features of necrotizing fasciitis and highlights the Bacillus cereus-induced necrotizing fasciitis for physicians in order to promote timely intervention for septic shock. View Full-Tex