Tiptoe Walking in the Presence of Superimposed Aeromonas With Dengue Infection

Abstract

The rise in limb salvage surgeries has led to an increase in post-traumatic equinus contractures, resulting in secondary causes of tiptoe walking. There is notable evidence linking superimposed bacteremia to heightened risks of morbidity and mortality in dengue patients, particularly when the immune system is compromised, leading to documented cases of Aeromonas-induced necrotizing fasciitis with myonecrosis. A case report from August 2019 involves a five-year-old boy admitted for dengue fever, which progressed to severe bilateral leg necrotizing fasciitis caused by concurrent Aeromonas infection. The child further underwent urgent surgical debridement and post-operatively was diagnosed with necrotizing fasciomyositis of the bilateral leg. Despite urgent surgical intervention, the patient developed long-term complications of persistent equinus contractures in both legs, necessitating subsequent surgical Achilles tendon lengthening. This case underscores the potential fatality of superimposed Aeromonas septicaemia in dengue patients and emphasizes the need for vigilant monitoring and intervention in serious soft tissue infections in growing children and adolescents.