Necrotizing Fasciitis in Patients Who Underwent Renal Transplantation

A 48-year-old man receiving renal transplantation was admitted due to bacterial pneumonia. Unfortunately, he developed septic shock due to Escherichia coli-related necrotizing fasciitis (NF). To date, there have only been 11 such cases reported in the literature and this is the first case caused by E coli. An analysis of all 12 cases showed 83% of patients had the infection in the extremities, 27.3% of pathogens was Streptococcus pyogenes, 50% of patients had shock, but the mortality rate (16.7%) was no greater than that seen in non–renal transplant patients with NF. The elderly had higher mortality (P = .085) and patients taking mycophenoic acid had a higher risk of death (P = .039).