Necrotizing perineal fasciitis in two paraplegic nursing-home residents: CT imaging findings

Necrotizing fasciitis is a severe infection of the superficial fascia. Early recognition and aggressive management are essential to the treatment of this highly morbid disease. The clinical and physical findings are often the initial clues leading to the correct diagnosis. Computed tomography can play a crucial role in delineating the anatomy, evaluating for the extent of the infection, and for eventual complications. Before the advent of cross-sectional imaging, the majority of suspected patients underwent extensive surgical debridement procedures with resultant morbidity and mortality. We present two cases in which computed tomography played a major role in determining the need for emergent surgery and conservative management.