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Cellular Injury IV: Necrosis01:16

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Necrotizing fasciitis. Case report.

Mario Costanzo1, Laura Antonella Maria Caruso, Francesca Condorelli

  • 1Università degli Studi di Catania, Dipartimento Scienze chirurgiche, trapianti d'Organo e Tecnologie avanzate, Unità Operativa Clinicizzata di Endocrinochirurgia P.O.U. S. Luigi-S. Currb, Italy. mario.costanzo@unict.it

Annali Italiani Di Chirurgia
|December 20, 2008
PubMed
Summary
This summary is machine-generated.

Necrotizing fasciitis (NF), a severe infection of fascial planes, has a high mortality rate. This case highlights a rapidly progressing polymicrobial infection leading to multi-organ failure and death despite aggressive treatment.

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Area of Science:

  • Infectious Diseases
  • Pathology
  • Surgery

Background:

  • Necrotizing fasciitis (NF) is a rapidly progressive bacterial infection affecting deep and superficial fascial layers.
  • NF carries a significant mortality rate (20-40%) and requires prompt diagnosis and aggressive management.
  • Risk factors include obesity, diabetes mellitus, and chronic renal failure, as seen in this patient.

Observation:

  • A 57-year-old female presented with fever, left thigh pain, erythema, and swelling in the groin.
  • Clinical deterioration occurred rapidly within six hours, with hemorrhagic blisters and cutaneous necrosis.
  • The patient had multiple comorbidities including obesity, diabetes, chronic renal failure, and ischemic heart disease.

Findings:

  • Histopathological analysis revealed fascial necrosis, vascular thrombosis, and myonecrosis.
  • Cultures from tissue biopsies identified a polymicrobial infection.
  • Despite broad-spectrum antibiotics, surgical debridement, and daily wound care, the patient's condition worsened.

Implications:

  • This case underscores the aggressive nature of necrotizing fasciitis, even with timely intervention.
  • Polymicrobial infections can contribute to rapid progression and poor outcomes in NF.
  • Aggressive surgical and antibiotic management is crucial, but high mortality remains a challenge in severe cases.