Intestinal Perforation by a Toothpick as Reason for Necrotizing Fasciitis

Abstract

Necrotizing fasciitis is an uncommon but often fatal disease. Given the various causes of necrotizing fasciitis, we report a case of sigmoid colon perforation caused by a toothpick subsequently resulting in fulminant necrotizing fasciitis of the retroperitoneum and right thigh successfully treated by hemipelvectomy and Hartmann´s procedure.

Necrotizing fasciitis from an iliopsoas muscle abscess caused by a toothpick: A case report and literature review

“… Terminal ileum perforation Right pelvic region along iliopsoas muscle into buttock Bacteroides fragilis, Escherichia coli, and Prevotella spp. No No recollection 2018 Markus Rupp et al [ 4 ] 51 M Gas gangrene in the right lower abdomen and right leg. Surgical debridement was performed.…”

“…The mortality rate of psoas abscesses can reach 100% if left undiagnosed and untreated [ 1 ]. Moreover, psoas abscesses become more complicated to treat after they have progressed to necrotizing fasciitis [ 4 ]. The data of secondary psoas muscle abscess cause by ingested toothpick are limited in the literature.…”

From Lateral Ankle Sprain to Above-Knee Amputation: A Unique Case Report of Group A Streptococcus Necrotizing Soft-tissue Infection

“…However, in our literature review, we were unable to identify a case of an immunocompetent host who developed necrotizing fasciitis without a penetrating injury or inciting infection. Unique cases have been reported that include necrotizing fasciitis in an atraumatic immunocompromised host, another case from an intestinal perforation of a toothpick, and a another case from a simple cat bite [ 5 , 9 , 10 ].…”

“…Further, these infections are likely more aggressive in patients with serious medical comorbidities such as diabetes, obesity, kidney disease, vascular disease, drug/alcohol abuse, or advancing age sepsis [3,4]. Mortality rate is variable but approaches 100% without any treatment which is why prompt diagnosis is vital Dr. Zachary P Herzwurm Dr. Cameron S Murphy Dr. B Gage Griswold Dr. Colton R J Webber Dr. Kyle M Mahoney [5]. These infections can be grouped into polymicrobial and monomicrobial with polymicrobial representing 75% sepsis.…”

“…Further, these infections are likely more aggressive in patients with serious medical comorbidities such as diabetes, obesity, kidney disease, vascular disease, drug/alcohol abuse, or advancing age sepsis [ 3 , 4 ]. Mortality rate is variable but approaches 100% without any treatment which is why prompt diagnosis is vital [ 5 ].…”