Fusobacterium Nucleatum Causing Necrotizing Fasciitis of the Neck, Thorax, and Upper Limb: A Lemierre's-Like Case...

Necrotizing fasciitis (NF) is a rare "flesh-eating" entity with a high mortality rate due to late diagnosis. More specifically, this disease is deemed to be a subset of the aggressive skin and soft tissue infections (SSTIs) resulting in necrosis of the muscle fascia and subcutaneous tissues. It is usually caused by Gram-positive cocci specifically strains of Staphylococcus aureus and Streptococci or the combination of Gram-negative and anaerobic bacteria. If septic thrombophlebitis complicates a parapharyngeal abscess the clinical condition is referred to as Lemierre's syndrome (LS), which is also a rare entity and can result in necrotizing fasciitis of the neck and is usually caused by Fusobacterium necrophorum or Fusobacterium nucleatum. In our study, a rare case of a 61-year-old male patient who presented with progressed necrotizing fasciitis of his neck, chest, as well as his upper arm and a history of a bacterial throat infection in our emergency department is discussed. Despite treatment involving iv antibiotics and urgent radical surgical debridement, the patient unfortunately succumbed to his disease due to sepsis and secondary multiorgan failure.