Necrotizing Fasciitis Caused by Pseudomonas aeruginosa in an Immunocompromised Patient: A Case With Fulminant Evolution

Necrotizing fasciitis is a rare, life-threatening infection involving the subcutaneous tissue and fascia, with potential for rapid progression and high mortality. Here, we report the case of a 56-year-old woman with a history of chronic lymphocytic leukemia (under watchful waiting), hypogammaglobulinemia, and megaloblastic anemia who was admitted to the emergency department with progressive swelling of her right forearm following an insect bite. The patient rapidly developed septic shock with multiorgan failure. Broad-spectrum antibiotics were started, and she underwent urgent surgical debridement. Despite intensive care measures, the patient died within hours of admission. Cultures from the wound and blood grew <i>Pseudomonas aeruginosa</i>. This case illustrates the extreme virulence of <i>Pseudomonas aeruginosa</i> in necrotizing soft tissue infections, particularly in immunocompromised hosts. Early recognition and aggressive multidisciplinary intervention remain key to improving outcomes in this life-threatening condition.