Retroperitoneal Necrotizing Fasciitis Following Prolonged Physical Activity: A Case Report.

Area of Science:

• Nephrology
• Infectious Diseases
• Critical Care Medicine

Background:

• Retroperitoneal necrotizing fasciitis is a rare, aggressive infection with often unclear origins and potential absence of skin manifestations.
• Necrotizing fasciitis can lead to severe complications, including acute kidney injury (AKI).

Observation:

• A 64-year-old female with comorbidities developed acute kidney injury and retroperitoneal necrotizing fasciitis after a bike ride.
• Initial symptoms included myalgia, nausea, vomiting, and flank pain, with diagnostic findings of myositis and severe AKI.

Findings:

• Despite aggressive medical management, the patient experienced septic shock and multiorgan failure, resulting in mortality.
• This case underscores the rapid progression and challenges in managing necrotizing fasciitis complicated by rhabdomyolysis-induced AKI.

Implications:

• Early identification and prompt, aggressive treatment are vital for suspected necrotizing fasciitis and AKI.
• Absence of cutaneous signs should not delay diagnosis; early multidisciplinary team involvement is crucial for complex cases.