Table 1 Summary of the clinical, microbiological and histopathological findings
From: Zoonotic necrotizing myositis caused by Streptococcus equi subsp. zooepidemicus in a farmer
Day 2 | Day 3 | Day 4 | Day 5 | Day 6 | Day 7 | Day 8 | Day 9 | Day 11 | Day 14 | |
|---|---|---|---|---|---|---|---|---|---|---|
Surgery | Excision of necrotic tissue | Excision of necrotic tissue | Excision of necrotic tissue | Excision of necrotic tissue | Inspection and wound debridement | Inspection and wound debridement | Surgical closure | |||
Antibiotics | Pen G + Clinda + Genta | Pen G + Clinda + Gentamicin | Pen G+ Clinda | Pen G + Clinda | Pen G + Clinda | Pen G + Clinda | Pen G + Clinda | Clinda + Cefta+ Cipro | Pen G + Clinda+ Cipro | Pen G + Cipro |
Microbiology and pathology | Streptococci isolated from blood and tissue. Histo-pathological findings compatible with necrotizing myositis | Confirmed species-identifi-cation of S. equi. | P. aeruginosa, Bacteroides spp. and S. equi from infected soft tissue | Confirmed subspecies-identification of S. equi. subsp. zooepidemicus | ||||||
Organ dysfunctiona | Circulatory Respiratory Coagulation | Circulatory Respiratory Renal Coagulation | Circulatory Respiratory Renal Coagulation | Circulatory Respiratory Renal Coagulation | Respiratory Renal Coagulation | Respiratory Renal Coagulation | Respiratory Renal Coagulation | Respiratory Renal Coagulation | Respiratory Coagulation | |
SOFA-scoreb | 11 | 13 | 14 | 13 | 7 | 9 | 5 | 3 | ||
Vasopressors | NA | NA + Vasopressin | NA + Vasopressin | NA + Vasopressin | ||||||
HBO-therapy | Yes | Yes | ||||||||
CVVHF | Yes | Yes | ||||||||
Respirator | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes |