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CASE REPORT article

Front. Med.
Sec. Infectious Diseases: Pathogenesis and Therapy
Volume 11 - 2024 | doi: 10.3389/fmed.2024.1392430

A case of widespread soft tissue infection and multiple abscesses secondary to hidradenitis suppurativa inducing septic shock caused by Lawsonella clevelandensis in China

Provisionally accepted
Zhi Lijia Zhi Lijia 1Qi Jiachao Qi Jiachao 2*Li Li Li Li 3Deng Shikun Deng Shikun 4Peiyang Gao Peiyang Gao 1*
  • 1 Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China
  • 2 Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, China
  • 3 Chengdu Integrated TCM and Western Medical Hospital, Chengdu, Sichuan Province, China
  • 4 Chengdu Xinjin District Hospital of Traditional Chinese Medicine, Chengdu, Sichuan Province, China

The final, formatted version of the article will be published soon.

    Lawsonella clevelandensis is rare to associated with human infection which may cause abscesses in abdominal cavity, liver, breast and spine. L. clevelandensis is very difficult to be cultivated in regular manner, detection of 16S rRNA sequence is the main evidence for L. clevelandensis infection. The clinical manifestations of L. clevelandensis infection resemble other agents of Nocardia, Tuberculosis and non-tuberculous Mycobacterium (NTM) due to their morphologic similarities. Hidradenitis suppurativa (HS), is a chronic inflammatory disorder, which affects the intertriginous skin and is associated with numerous systemic comorbidities. HS eventually leads to severe pain, multiple abscesses, pus discharge and irreversible tissue destruction. L. clevelandensis has not been reported to cause HS and systemic comorbidities. We presented the case of a 33-year-old male with widespread soft tissue infection and multiple abscesses secondary to HS (Hurley stage III) inducing septic shock caused by L. clevelandensis in China. He was diagnosed as HS and treated with intravenous antibiotic empirically. He developed multiple abscesses including lung and scrota. Bacterial and fungal cultures on blood and secretions from multiple skin lesions were all negative. Due to the misdiagnosis and progression of disease, he developed multiple abscesses including lung and scrota. tThe patient was transferred to intensive care unit, and he underwent drainage of the chest and right hemothorax removal under thoracoscopic. During the hospitalization, the patient developed septic shock and received mechanical ventilation. Computerized tomography (CT) scans revealed mediastinal emphysema, multiple subcutaneous emphysema and severe pneumonia. Gene analysis of samples of incision and drainage of pus at the skin showed the rare infection of L. clevelandensis. Finally, the patients with

    Keywords: Lawsonella clevelandensis, Widespread soft tissue infection, Hidradenitis Suppurativa, Multiple abscesses, next generation sequencing

    Received: 28 Feb 2024; Accepted: 17 Jul 2024.

    Copyright: © 2024 Lijia, Jiachao, Li, Shikun and Gao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Qi Jiachao, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, China
    Peiyang Gao, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China

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