# A kidney transplant recipient with shingles and necrotizing bacterial superinfection: a case report

## TL;DR

A kidney transplant patient developed a rare and severe bacterial skin infection after a virus infection, requiring intensive treatment.

## Contribution

This case highlights the rare occurrence of Pseudomonas aeruginosa causing necrotizing infection in immunocompromised transplant recipients.

## Key findings

- Pseudomonas aeruginosa caused a monomicrobial necrotizing infection in a kidney transplant recipient.
- The patient required intubation due to airway compromise but recovered with preserved kidney function.
- Residual facial nerve palsy was the only long-term complication observed.

## Abstract

We report a 45-year-old kidney transplant recipient who developed primary varicella zoster virus infection complicated by monomicrobial necrotizing skin and soft tissue infection caused by Pseudomonas aeruginosa. Progressive facial and oropharyngeal edema led to airway compromise requiring endotracheal intubation. Blood and wound cultures grew Pseudomonas aeruginosa, and targeted therapy with meropenem resulted in clinical improvement. The patient recovered with preserved allograft function but was left with residual facial nerve palsy. Pseudomonas aeruginosa–associated monomicrobial necrotizing skin and soft tissue infections are rare, occur predominantly in immunocompromised patients, and can be life-threatening.