Case Report Fatal Acinetobacter baumanii Necrotizing Fasciitis following Open Reduction Internal Fixation in a Polytrauma Patient Alexandre Nehme , Nabih I. Joukhadar, Elias Saidy, Mohammad Darwiche, Dany K. Aouad , and Hicham G. Abdel Nour Department of Orthopedic Surgery and Traumatology, Saint Georges University Medical Center, Balamand University, P.O. Box 166378, Achrafieh, Beirut 1100 2807, Lebanon Correspondence should be addressed to Hicham G. Abdel Nour; hicham.abdelnour.dr@gmail.com Received 10 March 2018; Accepted 7 June 2018; Published 21 June 2018 Academic Editor: Paola Di Carlo Copyright © 2018 Alexandre Nehme et al. is is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Necrotizing fasciitis is an uncommon and potentially fatal infection that can affect the epidermis, dermis, and more commonly the subcutaneous, fascia, and muscle layers. NF is usually caused by toxin-producing bacteria with a relatively fast progression associated with severe surrounding tissue destruction. Early diagnosis and management are crucial factors for survival. Broad- spectrum antibiotics along with surgical debridement, sometimes multiple, are needed in order to stop or slow down the progression of NF. Despite optimal care, necrotizing fasciitis remains a highly morbid condition with a high mortality rate. We present a case of a 28-year-old male patient with rapidly developing fatal A. baumannii associated with necrotizing fasciitis, after open reduction and internal fixation (ORIF) of multiple fractures after polytrauma. 1. Introduction Necrotizing fasciitis (NF) is a rare, life-threatening bacterial infection leading to necrosis of the fascia, underlying skin, subcutaneous tissue, and vasculature associated with high morbidity and mortality. Necrotizing fasciitis could affect the perineum, the genital area, and most commonly the lower extremities [1–3], with a male-to-female ratio of 3 :1 in terms of predominance [1]. It is a rapidly progressing condition, making timely clinical diagnosis challenging and taking immediate mea- sures the most important factors for survival and treatment. Some predisposing conditions are diabetes mellitus, alco- holism, hypertension, and malignancies. In addition to these conditions, obesity, chronic kidney dysfunction, and lym- phocytic dysfunction leading to immunosuppression are all predisposing factors to NF [4–6]. NF is often misdiagnosed as cellulitis or other similar skin and soft tissue infections such as erysipelas [1]. It is a polymicrobial infection in approximately 70% of cases. e most common pathogens associated with necrotizing fasciitis include group A beta-hemolytic Strep- tococcus, group B Streptococcus, Enterococci, coagulase- negative Staphylococci, Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, Bacteroides, and Clostridium [7]. Acinetobacter baumannii is rarely associated with necrotizing fasciitis, especially in immunocompetent hosts [8]. We report an unusual case of a male patient with rapidly developing fatal A. baumannii associated with necrotizing fasciitis, after open reduction and internal fixation (ORIF) of multiple fractures after polytrauma. 2. Case Report is is a case of a 28-year-old male patient, previously healthy, with no past surgical history. He was transferred to our facility from a peripheral hospital due to multiple fractures and crush injuries sustained after a motor vehicle accident one week prior to presentation. e patient had a butterfly fracture at the junction of the proximal and middle thirds of the left femur (already treated Hindawi Case Reports in Infectious Diseases Volume 2018, Article ID 4176320, 5 pages https://doi.org/10.1155/2018/4176320