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Necrotizing fasciitis
Virendra N Sehgal1, Naresh Sehgal, Ruchi Sehgal
1Dermato-Venereology (Skin/VD) Centre, Sehgal Nursing Home, Panchwati, Azadpur, Delhi, India. drsehgal@ndf.vsnl.net.in
Abstract:
Necrotizing fasciitis is an uncommon, rapidly spreading infection, affecting primarily the deep fascia, which may result in secondary necrosis of the subcutaneous tissue, fascia and muscle. We report a patient that had the cardinal features; namely, excruciatingly painful lesions, demonstration of gas in the tissue and an obnoxious foul odor, prominent erythema, induration, patchy necrosis, and loss of sensation in the left buttock and thigh. Its onset probably followed inadvertent trauma/injury of the left buttock. Corroborative microscopic pathology confirmed the diagnosis. Debridement and intensive supportive therapy comprising antibiotics, analgesics and fluids were given. The outcome of the therapy was gratifying.
Insights
Necrotizing fasciitis, a severe deep fascia infection, presents with pain, gas in tissue, and foul odor. Prompt debridement and supportive care led to a positive outcome in a recent case.
Area of Science:
- Infectious Diseases
- Surgical Pathology
Background:
- Necrotizing fasciitis is a rare, aggressive soft tissue infection primarily involving deep fascia.
- It can rapidly progress to subcutaneous tissue, fascia, and muscle necrosis.
- Early recognition and intervention are critical for patient outcomes.
Observation:
- A patient presented with excruciating pain, palpable gas in tissues, and a foul odor in the left buttock and thigh.
- Physical examination revealed erythema, induration, patchy necrosis, and sensory loss.
- Symptoms likely followed minor trauma to the affected area.
Findings:
- Microscopic pathology confirmed the diagnosis of necrotizing fasciitis.
- The clinical presentation included cardinal signs of the infection.
- The patient received surgical debridement and intensive supportive therapy.
Implications:
- This case highlights the importance of recognizing the characteristic signs of necrotizing fasciitis.
- Aggressive surgical management combined with antibiotics, analgesics, and fluids can lead to favorable outcomes.
- Prompt diagnosis and treatment are essential to prevent severe morbidity and mortality associated with this infection.
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