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Necrotizing Fasciitis Presenting as Generalized Weakness, Malaise, and Acute Kidney Injury
Laurence Stolzenberg1, Alexis Koch2, Austin Huang3
1Orthopedic Surgery, Alabama College of Osteopathic Medicine, Dothan, USA.
Cureus
|December 22, 2022
Summary
Necrotizing fasciitis (NF), a severe infection, can mimic milder skin conditions. Early recognition of systemic symptoms and abnormal labs is crucial for prompt surgical intervention and survival.
Area of Science:
- Medicine
- Surgery
- Infectious Diseases
Background:
- Necrotizing fasciitis (NF) is a rapidly progressive soft tissue infection requiring urgent surgical management.
- NF symptoms often overlap with less severe infections like cellulitis, complicating early diagnosis.
- Prompt diagnosis and intervention are critical to prevent mortality and severe morbidity.
Observation:
- A patient presented with malaise and weakness, initially reporting a minor cutaneous complaint.
- Abnormal renal function tests (RFTs) indicated acute kidney injury.
- Abdominal/pelvic CT revealed subcutaneous emphysema, raising suspicion for NF.
Findings:
- Clinical suspicion of NF was confirmed by surgical exploration and debridement of necrotic tissue.
- The patient, a non-diabetic female, had a rare presentation of Fournier's gangrene.
- Systemic symptoms and abnormal RFTs were key indicators in this case.
Implications:
- This case highlights the importance of considering NF in patients with seemingly minor skin issues and systemic signs.
- Abnormal RFTs in the context of soft tissue infections warrant a high index of suspicion for NF.
- Thorough patient history, including seemingly unrelated symptoms, is vital for diagnosing emergent conditions like NF.
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