Detection of Leuconostoc in a Critically Ill Patient without Risk Factors

Hallazgo de Leuconostoc en Paciente Crítico sin Factores de Riesgo

Abstract

We present the case of a 5-month-old male infant who developed critical loss of the anterior abdominal wall secondary to necrotizing fasciitis after ileostomy closure for necrotizing enterocolitis. On admission, he presented with sepsis, adrenal insufficiency, severe malnutrition, and visceral exposure with enteroatmospheric fistulas, classified as Björk type IV open abdomen. Management included broad-spectrum antibiotics, parenteral nutrition, ileostomy remodeling, and advanced moist wound care with hydrocolloid and silver dressings. These measures enabled progressive granulation tissue formation and successful delayed abdominal closure. This case illustrates how an individualized multidisciplinary approach can achieve favorable resolution of catastrophic pediatric open abdomen, even under adverse clinical conditions.