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[Fulminant isolated necrotizing fasciitis of the chest wall, complicating thoracic empyema]
Ottó Kovács1, Zoltán Szántó1, Géza Krasznai2
1Sebészeti Osztály, Jász-Nagykun-Szolnok Megyei Hetényi Géza Kórház-Rendelőintézet 5000 Szolnok, Tószegi u. 21.
Abstract:
Authors introduce the case of a 64-year-old male patient with fulminant isolated necrotizing fasciitis of the chest wall, complicating empyema thoracis of unknown origin. The patient's co-morbidities were hypertension, ischaemic heart disease, atrial fibrillation with oral anticoagulation. The real etiology was revealed post mortem, due to the rapid progression. The autopsy demonstrated that the fasciitis was caused by a small blunt thoracic trauma (haematoma), not emerged from patient's history and was not visible during physical examination. Authors review diagnostic pitfalls, leading to delayed recognition in addition to this very case. After quick diagnosis surgical debridement, targeted wide spectrum antibiotics and maximal intensive care are the basic pillars of the management of necrotizing fasciitis.
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