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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  
  1. Pen G penicillin G, Clinda clindamycin, Genta gentamicin, Cefta ceftazidim, Cipro. ciprofloxacin, NA noradrenaline, HBO hyperbaric oxygen, CVVHF continuous venovenous hemofiltration, + plus
  2. a Organ dysfunction assessment according to Sequential Organ Failure (SOFA)-score
  3. b SOFA-score was not performed on day 2 and day 14