Rectum Perforation Complicated Necrotizing Fasciitis Present as Lumbar Disc Herniation: Case Report
Thian-Hwang Ho1,2, Sai-Wai Ho1,2
1Chung Shan Medical University Hospital Department of Emergency Medicine Taichung Taiwan.
Abstract:
Necrotizing fasciitis (NF) is an infection of the deep soft tissues that results in progressive destruction of the muscle fascia and overlying subcutaneous fat. These infections can be sudden, vicious, and fast-spreading. If not treated quickly with antibiotics and debridement of the infected tissue, the patient may develop septic shock, which may lead to multiple organ failure and death. NF is difficult to early diagnose due to the overlying tissue can appear unaffected initially. We report an unusual case of NF of the buttock and left thigh that clinically mimics lumbar disc herniation. This patient was successfully treated with emergent fasciotomy and intensive care. We recommend that patients with low back pain and unilateral leg pain should be diagnosed carefully especially keeping NF in differential diagnosis.
Insights
Necrotizing fasciitis, a severe soft tissue infection, can rapidly spread and be fatal if not treated promptly. Early diagnosis is crucial, as it can mimic other conditions like lumbar disc herniation.
Area of Science:
- Infectious Diseases
- Surgical Pathology
Background:
- Necrotizing fasciitis (NF) is a rapidly progressive, deep soft tissue infection causing extensive destruction of fascia and subcutaneous fat.
- Delayed diagnosis of NF can lead to severe complications including septic shock, multiple organ failure, and death.
- Initial presentation of NF can be deceptively benign, with overlying tissues appearing unaffected, complicating early recognition.
Purpose of the Study:
- To report an unusual case of necrotizing fasciitis presenting as lumbar disc herniation.
- To highlight the importance of considering NF in the differential diagnosis of low back and unilateral leg pain.
Main Methods:
- Case report of a patient with necrotizing fasciitis of the buttock and left thigh.
- Clinical presentation mimicking lumbar disc herniation.
- Successful treatment with emergent fasciotomy and intensive care.
Main Results:
- The patient's necrotizing fasciitis presented with symptoms mimicking lumbar disc herniation.
- Prompt surgical intervention (fasciotomy) and intensive care led to successful patient outcomes.
- The case underscores the diagnostic challenges associated with atypical NF presentations.
Conclusions:
- Necrotizing fasciitis can present atypically, mimicking common conditions such as lumbar disc herniation.
- A high index of suspicion and careful diagnostic evaluation are essential for patients with low back and unilateral leg pain.
- Early recognition and aggressive management, including fasciotomy, are critical for improving outcomes in necrotizing fasciitis.
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