Necrotizing fasciitis--a diagnostic dilemma: two case reports

Area of Science:

• Infectious Diseases
• Surgical Pathology

Background:

• Necrotizing soft tissue infections (NSTIs) present with diverse etiologies, often involving impaired immunity and compromised tissue barriers.
• Nonspecific symptoms can delay diagnosis, increasing the risk of severe outcomes and mortality.

Observation:

• Two cases of necrotizing fasciitis are presented: a healthy male with trauma and an immunocompromised female with lupus.
• Both patients experienced rapid deterioration, with one developing intestinal obstruction and the other septic shock, leading to fatal outcomes despite medical intervention.

Findings:

• Necrotizing fasciitis was diagnosed via clinical presentation and confirmed with magnetic resonance imaging.
• Despite prompt surgical debridement in one case, the advanced infection led to mortality.

Implications:

• Necrotizing fasciitis requires a high index of suspicion among clinicians and surgeons due to its potentially lethal nature.
• Early diagnosis and aggressive intervention are critical for improving patient outcomes and reducing mortality in NSTIs.