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Related Experiment Videos

[Swollen leg with blisters].

Ph Rafeiner1, A J Templeton, H J Vonesch

  • 1Medizinische Klinik, Spital Zofingen. RafeinerP@uhbs.ch

Praxis
|October 26, 2005
PubMed
Summary

A severe leg pain mimicking deep vein thrombosis in an elderly woman was actually necrotizing fasciitis. This streptococcal toxic shock syndrome led to a fatal outcome, highlighting critical diagnostic challenges.

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Area of Science:

  • Medicine
  • Infectious Diseases
  • Surgery

Background:

  • Necrotizing fasciitis is a severe bacterial infection that rapidly destroys soft tissue.
  • Early diagnosis is crucial for effective management and improved patient outcomes.
  • Streptococcus pyogenes (group A Streptococcus) is a common causative agent.

Observation:

  • An 84-year-old woman presented with severe right leg pain, initially suspected as deep vein thrombosis.
  • Superficial blisters with hemorrhagic aspects and fluid eruption developed on her calf and thigh.
  • The patient's condition rapidly deteriorated, leading to death within 33 hours of admission.

Findings:

  • The patient was diagnosed with streptococcal toxic shock syndrome secondary to necrotizing fasciitis.
  • Streptococcus pyogenes was identified in blood and blister fluid cultures.
  • The characteristic symptom of "pain out of proportion" was noted.

Implications:

  • This case underscores the importance of recognizing "pain out of proportion" as a key indicator of necrotizing fasciitis.
  • Prompt surgical intervention and antibiotic therapy are vital for managing this aggressive infection.
  • Timely diagnosis and treatment can significantly impact patient survival rates in severe soft tissue infections.

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