case_images: PMC5733867_01
case_images: Marked swelling with discoloration of the dorsum of the left hand following cat bite.
case_images: CRICC2017-3718360.001.jpg
case_images: PMC5733867_01_CRICC2017-3718360.001.jpg
case_images: fig1
case_images: 57-year-old female with history of rheumatoid arthritis on oral corticosteroid and methotrexate therapy was admitted to the hospital for the evaluation of painful swelling of the left hand (Figure 1).
case_images: After surgical excisional debridement of skin, subcutaneous tissue, and muscle of hand and forearm.
case_images: CRICC2017-3718360.002.jpg
case_images: PMC5733867_01_CRICC2017-3718360.002.jpg
case_images: fig2
case_images: Hand surgeon was consulted and she underwent immediate surgical excisional debridement of skin, subcutaneous tissue, and muscle of hand and forearm (Figure 2).
case_images: CT of chest showing bilateral infiltrates.
case_images: CRICC2017-3718360.003.jpg
case_images: PMC5733867_01_CRICC2017-3718360.003.jpg
case_images: fig3
case_images: In spite of all the adequate therapy for the necrotizing fasciitis, streptococcal toxic shock syndrome, and acute kidney injury, her hospital course was complicated by acute respiratory failure secondary to acute respiratory distress syndrome (Figure 3) and deep vein thrombosis with paradoxical embolism and cerebrovascular accident.