Related Experiment Video
Updated: Sep 29, 2025
Mouse Model of Pressure Ulcers After Spinal Cord Injury
Published on: March 9, 2019
Paraspinal Necrotizing Fasciitis Associated with Pressure Injury: An Unusual Case Report
Min Ji Kim1, Kyung Min Yang, Hyoseob Lim
1In the Department of Plastic and Reconstructive Surgery, Ajou University School of Medicine, Suwon, Korea, Min Ji Kim, MD, PhD, is Assistant Professor; Kyung Min Yang, MD, is Resident; and Hyoseob Lim, MD, PhD, is Associate Professor.
Abstract:
Necrotizing fasciitis is a type of soft tissue infection that destroys subcutaneous tissue. It is particularly dangerous for patients with chronic diseases and those who are bedridden while recuperating. Although necrotizing fasciitis is often caused by trauma or postoperative infection, in rare cases, it can be attributed to pressure injury (PI). The disease progression is very aggressive and can be lethal for patients who are bedridden or immunocompromised.This case report describes a 47-year-old man with a history of diabetes and hypertension who became bedridden after a sudden status decline caused by nephrotic syndrome. He gradually developed an infection and rare deterioration of a PI on his upper back. After radiologic evaluation with magnetic resonance imaging and computed tomography, surgical intervention was performed and necrotizing fasciitis was confirmed. In this case of necrotizing fasciitis derived from a PI on the upper back, the infected area spread to the periphery at a rapid rate. The infection spread over his back and across the T1-T9 levels.In this report, the authors describe the integrated system of the thoracolumbar fascia and the very aggressive spread of necrotizing fasciitis. Because of the anatomic structure of the back and the characteristics of this infection, only aggressive surgical debridement could prevent the spread of infection and reduce the systemic effects of the infection. Physicians should be aware of the possibility of PIs in bedridden patients and, in cases of exacerbation of the wound, consider rapid surgical intervention after prompt examination and diagnosis to reduce mortality.
Insights
Necrotizing fasciitis, a severe soft tissue infection, can rarely develop from pressure injuries (PI) in bedridden patients. Prompt surgical debridement is crucial for managing this aggressive condition and preventing mortality.
Area of Science:
- Infectious Diseases
- Surgical Pathology
- Dermatology
Background:
- Necrotizing fasciitis is a rapidly progressive soft tissue infection.
- It poses significant risks to immunocompromised and bedridden individuals.
- While often linked to trauma or surgery, it can arise from pressure injuries (PI).
Observation:
- A case report details a 47-year-old male with diabetes and hypertension, bedridden due to nephrotic syndrome.
- The patient developed a rare, aggressive necrotizing fasciitis originating from a pressure injury on his upper back.
- Infection rapidly spread across the T1-T9 levels, involving the thoracolumbar fascia.
Findings:
- Radiologic imaging (MRI, CT) confirmed necrotizing fasciitis secondary to a PI.
- Surgical intervention revealed the aggressive nature and extensive spread of the infection.
- The anatomical structure of the back facilitated rapid peripheral spread.
Implications:
- Physicians must consider necrotizing fasciitis in bedridden patients with deteriorating PIs.
- Early diagnosis and aggressive surgical debridement are critical for preventing mortality.
- Understanding fascial planes is key to managing this severe infection.
