An atypical case of necrotizing fasciitis secondary to perforated cecal cancer

Heidelberg, Laura S; Pettke, Erica; Wagner, Teresa; Angotti, Lauren

doi:10.1093/jscr/rjaa371

Cited by 7 publications

(14 citation statements)

References 8 publications

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“…Furthermore, examination based on context such as finding soft issue infection in patients with burns may be helpful [ 47 , 48 ]. Repeated examinations were helpful to identify source of infection in patients who did not initially have localizing signs [ 49 ]. Nonspecific signs such as lymphadenopathy or maculopapular rash may suggest lymphoma or rheumatological conditions, such as Adult Onset Still’s Disease, respectively [ 50 , 51 ].…”

Section: Resultsmentioning

confidence: 99%

“…Point of care ultrasound was demonstrated to be useful to assess many body compartments including pulmonary, urinary, biliary and musculoskeletal [ 55 – 57 ]. Computed tomography (CT) was often reported as a helpful screening tool to increase diagnostic yield when source of sepsis is unknown [ 26 , 31 , 39 , 49 , 51 , 57 – 63 ]. Along with plain radiographs, ultrasound and echocardiography, studies have generally recommended that it is essential to perform a screening CT scan before a diagnosis of SUO is made [ 25 , 28 – 30 , 32 , 33 ].…”

Section: Resultsmentioning

confidence: 99%

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Scoping review on diagnostic criteria and investigative approach in sepsis of unknown origin in critically ill patients

Mui

Lefrant

Stelfox³

et al. 2022

j intensive care

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Background Up to 11% of critically ill patients with sepsis have an unknown source, where the pathogen and site of infection are unclear. The aim of this scoping review is to document currently reported diagnostic criteria of sepsis of unknown origin (SUO) and identify the types and breadth of existing evidence supporting diagnostic processes to identify the infection source in critically ill patients with suspected SUO. Methods A literature search of Embase, MEDLINE and PubMed for published studies from 1910 to August 19, 2021 addressing the topic of SUO was performed. Study type, country of origin according to World Bank classification, diagnostic criteria of sepsis of unknown origin, and investigative approaches were extracted from the studies. Results From an initial 722 studies, 89 unique publications fulfilled the inclusion and exclusion criteria and were included for full text review. The most common publication type was case report/series 45/89 (51%). Only 10/89 (11%) of studies provided a diagnostic criteria of SUO, but a universally accepted diagnostic criterion was not identified. The included studies discussed 30/89 (34%) history, 23/89 (26%) examination, 57/89 (64%) imaging, microbiology 39/89 (44%), and special tests 32/89 (36%) as part of the diagnostic processes in patients with SUO. Conclusions Universally accepted diagnostic criteria for SUO was not found. Prospective studies on investigative processes in critically ill patients managed as SUO across different healthcare settings are needed to understand the epidemiology and inform the diagnostic criteria required to diagnose SUO.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Scoping review on diagnostic criteria and investigative approach in sepsis of unknown origin in critically ill patients

Mui

Lefrant

Stelfox³

et al. 2022

j intensive care

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“…His initial visit to the outside emergency department might have been the initial presentation of perforation of his cecum. NF of the retroperitoneum, abdominal wall, and perineum have all been reported to result from intestinal perforation/rupture [12][13][14]. Also, there is a possibility that this was a cancerous growth.…”

Section: Variablesmentioning

confidence: 99%

Necrotizing Fasciitis Masquerading as Stroke: A Diagnostic Dilemma

Locklear,

Holland,

Biswas

2024

Cureus

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Necrotizing fasciitis (NF) poses a diagnostic challenge due to its rarity and similarity in presentation with other critical conditions. We report a case of a 79-year-old male who initially presented with altered mental status and stroke-like symptoms; he was ultimately diagnosed with abdominal wall NF spreading to the lower extremity. Despite a history of cecal mass perforation noted in prior imaging, the patient had been discharged from an outside emergency room on antibiotics, highlighting a missed opportunity for early intervention. Subsequent deterioration led to sepsis, organ failure, and ultimately, the detection of NF. Prompt recognition of subtle skin changes and laboratory abnormalities, along with a detailed physical examination, is essential for a timely and accurate diagnosis. Surgical debridement, coupled with broadspectrum antibiotics, remains the cornerstone of treatment. Delays in surgical management significantly increase mortality, emphasizing the importance of prompt diagnosis and intervention. This case underscores the necessity for heightened awareness among healthcare providers to recognize NF promptly, especially when its clinical presentation overlaps with other critical conditions. Multidisciplinary collaboration and continued education are imperative to improve outcomes and prevent delays in the diagnosis and treatment of NF.

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“…Necrotizing fasciitis (NF) is an aggressive, rapidly progressive, life-threatening infection [ 1 ]. Dr B. Wilson coined this term for the first time in 1952 [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

“…Dr B. Wilson coined this term for the first time in 1952 [ 2 ]. It can lead to necrosis in the skin, subcutaneous fat, and superficial and deep muscle fascia [ 3 ], and has an incidence of 0.5–15 cases in every 100 000 population [ 1 ]. Most patients with NF have preexisting medical conditions such as diabetes mellitus, immune suppression, liver and kidney diseases, and malignancy [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Lower extremity necrotizing fasciitis with iliopsoas abscess secondary to perforated colon cancer: a diagnosis not to miss

Lahham,

Alsahouri,

Ghweir

et al. 2023

Journal of Surgical Case Reports

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Necrotizing fasciitis (NF) is a life-threatening soft tissue infection, typically caused by preexisting conditions such as trauma, complicated intraabdominal infections, or even small wounds. However, it is very rare for NF to occur as a result of perforated colon cancer (CC). Diagnosis primarily relies on clinical findings, imaging, and laboratory tests. Early diagnosis and treatment are crucial for patient survival. In this study, we present a case of an 82-year-old female a known case of CC diagnosed 1 month ago. She presented with hip pain persisting for 10 days duration, along with skin changes over the proximal anterolateral aspect of the thigh. The patient was diagnosed with NF associated with an iliopsoas abscess caused by perforated CC that was managed with surgical debridement, left hemicolectomy, and end colostomy along with broad-spectrum antibiotics.

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An atypical case of necrotizing fasciitis secondary to perforated cecal cancer

Cited by 7 publications

References 8 publications

Scoping review on diagnostic criteria and investigative approach in sepsis of unknown origin in critically ill patients

Scoping review on diagnostic criteria and investigative approach in sepsis of unknown origin in critically ill patients

Necrotizing Fasciitis Masquerading as Stroke: A Diagnostic Dilemma

Lower extremity necrotizing fasciitis with iliopsoas abscess secondary to perforated colon cancer: a diagnosis not to miss

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