Necrotizing Fasciitis from a Percutaneous Transhepatic Biliary Drainage Site

Abstract

Percutaneous transhepatic biliary drainage (PTBD) is the established method of treatment for benign or malignant biliary obstruction. Although relatively safe, the procedure is associated with complications including intraperitoneal bile leak, pancreatitis, cholangitis, biliary peritonitis, and hemorrhage. Extraperitoneal complications are rare. Here, we document a case in which necrotizing fasciitis developed in the extraperitoneal plane surrounding the transcutaneous drainage site. The patient was managed with PTBD removal, drainage and debridement of necrotic tissues, and intravenous antibiotics.

Klebsiella pneumoniae necrotizing fasciitis on the upper lip in a patient with uncontrolled diabetes

“…In the case presented by Ku and Park [18], a mid-face NF patient with uncontrolled DM had a wound infected by K. pneumoniae and group B streptococcus. Choi et al [19] also reported a case of mixed infection by K. pneumoniae, Enterococcus faecalis, and Candida species in a flank NF patient with DM. In this case, however, K. pneumoniae appeared alone in the initial culture, and MRSA appeared as a mixed pathogen afterwards.…”