Necrotizing Fasciitis Post-Cesarean Section Leading to Transabdominal Hysterectomy.

Area of Science:

• Medicine
• Infectious Diseases
• Surgery

Background:

• Necrotizing fasciitis (NF) is a severe soft tissue infection with high morbidity and mortality.
• Literature on NF involving solid organs beyond fascial planes is limited.
• Postpartum women are susceptible to severe infections following cesarean delivery.

Observation:

• A 25-year-old female developed NF involving the uterus and abdominal wall post-cesarean section.
• The condition necessitated a total abdominal hysterectomy, serial debridement, and wound vacuum-assisted closure (VAC).
• Pathology confirmed uterine infiltration by polybacteria, indicative of NF.

Findings:

• Early diagnosis of NF is challenging due to non-specific symptoms.
• The Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score aids in early detection using routine laboratory values.
• Polymicrobial bacterial infiltration of the uterus was confirmed.

Implications:

• This case underscores the importance of considering NF in postpartum patients with severe abdominal wall infections.
• Prompt diagnosis and aggressive surgical management are crucial for survival.
• A multidisciplinary team approach is vital for managing complex NF cases, especially in postpartum settings.