A Fatal Case of Super-super Obesity (BMI >80) in a Patient with a Necrotic Soft Tissue Infection

Toshihiko Yoshizawa; Kouhei Ishikawa; Hiroki Nagasawa; Ikuto Takeuchi; Kei Jitsuiki; Kazuhiko Omori; Hiromichi Ohsaka; Youichi Yanagawa

doi:10.2169/internalmedicine.9277-17

CASE REPORTS

A Fatal Case of Super-super Obesity (BMI >80) in a Patient with a Necrotic Soft Tissue Infection

Toshihiko Yoshizawa, Kouhei Ishikawa, Hiroki Nagasawa, Ikuto Takeuchi, Kei Jitsuiki, Kazuhiko Omori, Hiromichi Ohsaka, Youichi Yanagawa

Author information

Toshihiko Yoshizawa
Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Japan
Kouhei Ishikawa
Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Japan
Hiroki Nagasawa
Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Japan
Ikuto Takeuchi
Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Japan
Kei Jitsuiki
Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Japan
Kazuhiko Omori
Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Japan
Hiromichi Ohsaka
Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Japan
Youichi Yanagawa
Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Japan

Keywords: super-super obesity, cellulitis, Streptococcus dysgalactiae

JOURNAL OPEN ACCESS

2018 Volume 57 Issue 10 Pages 1479-1481

DOI https://doi.org/10.2169/internalmedicine.9277-17

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Abstract

A 35-year-old man (height, 169 cm; body weight, 240 kg; BMI, 84) visited the Department of Dermatology due to left leg pain and swelling. Focused enhanced computed tomography (CT) of the left leg ruled out complications of deep venous thrombosis. Surgical exploration of the left leg resulted in a diagnosis of necrotic soft tissue infection, but amputation was ruled out due to his weight. The patient ultimately died of multiple organ failure on the fourth day of hospitalization. A culture of the surgical material revealed Streptococcus dysgalactiae. The present case suggests that super-obese patients should be aggressively treated before lethal complications occur.

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