Recurrent Necrotizing Fasciitis: A Case Report of Fulminant and Sub-Acute Necrotizing Fasciitis in a Diabetic Patient

Mujdragić

et al. 2021

IntroductionNecrotizing fasciitis is a severe inflammatory disease of the body's soft tissue characterized by spreading rapidly and high mortality. Rapid surgical intervention along with other supportive measures of treatment have a great impact on the outcome of treatment. Material and methodsThis study was conducted by a retrospective medical record review of all patients with a microbiologically and clinically confirmed diagnosis of necrotizing fasciitis who were admitted to the general surgery department at the General Hospital Novi Pazar, Serbia, during the period between 2017 and 2020. Demographic, clinical, laboratory, and microbiology data were analyzed. ResultsA total of 13 cases were identified, which represents 0.21% of the total number of patients treated at the surgical department during the period January 2017 to November 2020. The mean age of patients was 55 years, with a male/female ratio of 1:1.6. All of them had at least one comorbidity and more than half had three or more. Diabetes, cardiovascular diseases, and obesity were the most common comorbidities. The most common causes of infection were Klebsiella spp, Pseudomonas aeruginosa, S. pyogenes, and S. aureus. All patients received multiple surgical interventions (mean 2.3). ConclusionTreating necrotizing fasciitis requires a multidisciplinary approach. Early diagnosis and rapid clinical response allow for better disease outcomes. Getting to know more about necrotizing fasciitis will help doctors make better decisions when treating it.

Section: Discussionmentioning

confidence: 99%

Necrotizing Soft Tissue Infection: A Single-Center Retrospective Study of Treatment and Outcomes

Mujdragić

et al. 2021

“…In addition, skin changes and crepitation may not be clear at the early phase of the disease. However, in the later stages of the disease, the skin may become numb due to nerve involvement in disease progression [8,9,10,11].…”

Section: Discussionmentioning

confidence: 99%

An Unexpected Turn: Management of a Life-Threatening Infection Following Liposuction Procedure (Case Report)

Morgom,

Eisa,

Ali

et al. 2024

This case report presents a rare case of necrotizing fasciitis (NF) following liposuction and lipofilling surgery in a young woman. Despite prompt diagnosis and aggressive management with multiple debridements, broad-spectrum antibiotics, and supportive care, the patient experienced a protracted course with severe complications, including intra-abdominal collection recurrence, heart failure, and sepsis. The presence of resistant bacteria (extended-spectrum beta-lactamases (ESBLs)-producing Escherichia coli and methicillinresistant Staphylococcus aureus (MRSA)) further challenged the treatment. This case highlights the importance of early recognition and aggressive management of NF, particularly in patients with risk factors following cosmetic surgery. In addition, it raises awareness of the potential for heart failure as a complication in this context and warrants further investigation.

“…The scoring system is based on six variables that add up to a total of 14 points and is shown in Table 2 . The six variables are as follows: C-reactive protein, WBC count, hemoglobin levels, sodium levels, creatinine levels, and glucose levels [ 2 - 4 , 9 , 11 ]. The score ranges from 0 to 14.…”

Section: Discussionmentioning

confidence: 99%

“…Other risk factors include obesity, alcoholism/liver disease, IV drug use, age > 60 years, peripheral vascular diseases, and an immunocompromised state. Triggers for NF include major trauma, recent surgery, and childbirth [ 4 - 9 ]. Common areas affected by NF are the lower extremities, pericardial areas, and external genitalia with less than 25% of patients affected in the anterior abdominal wall which is typically due to penetrating trauma [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Anterior Abdominal Wall Necrotizing Fasciitis Following Laparoscopic Sleeve Gastrectomy With Hiatal Hernia Repair: A Case Report

Fozo,

Thirunavukarasu,

Ogundolie

et al. 2024

Necrotizing fasciitis (NF), commonly known as necrotizing soft tissue infection (NSTI), or flesh-eating disease is a rare but rapidly fatal aggressive bacterial infection of soft tissue and deep skin that results in the destruction of the underlying fascia. Symptoms include fever, tachycardia, hypotension, leukocytosis, pain, and large areas of red and swollen skin. Early diagnosis and aggressive management are compulsory for a better prognosis. In this case report, we present a 58-year-old obese woman who initially presented to the emergency department three weeks post-sleeve gastrectomy with hernia repair and was initially suspected of having a large, uncomplicated abdominal wall abscess. Several repeated drainages of the abdominal wall abscess and continued deterioration of the patient revealed foul-smelling, necrotic tissue and the subsequent diagnosis of NF. This case report highlights the importance of high clinical suspicion for NF and early, aggressive debridement and treatment to improve patient outcomes.