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Published on: March 9, 2019
Necrotizing soft tissue infection from decubitus ulcer after spinal cord injury
Steven C Cunningham1, Lena M Napolitano
1Department of Surgery, Veterans Affairs Maryland Healthcare System, Baltimore, MD, USA.
Study Design:
A case of necrotizing soft tissue infection in a patient with spinal cord injury with extension of infection into the spinal canal and spinal cord is presented.
Objective:
To review the history, risk factors, pathophysiology, diagnosis, treatment, and morbidity and mortality regarding necrotizing soft tissue infection as they relate to spinal cord injury.
Summary Of Background Data:
Necrotizing soft tissue infection related to decubitus ulcers is rare. To our knowledge, this is the first report of this disease related to a sacral decubitus ulcer with extension of the necrotizing infection into the spinal canal.
Methods:
The clinical, radiographic, and pathologic features associated with necrotizing soft tissue infection are presented. The patient presented with a late-stage necrotizing soft tissue infection requiring extensive de-bridement of necrotic tissue, which the patient underwent on admission.
Results:
The patent died of refractory septic shock and multiple-organ failure after surgery.
Conclusion:
Necrotizing soft tissue infections from decubitus ulcers are rare and unpredictable, and ultimately have a progressively aggressive course. The case reported herein is the first report of necrotizing soft tissue infection from a decubitus ulcer in a patient with spinal cord injury with extension into the spinal canal and spinal cord.
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