Meleney's gangrene: A diagnostic pitfall in the context of lower lumbar hypoesthesia - A case study

Meleney's gangrene is one of the conditions classified under necrotizing "soft tissue infections". This uncommon illness has a high fatality rate and requires immediate diagnosis, aggressive antibiotic therapy, and extensive debridement. The mortality rate associated with Meleney's gangrene is approximately 34 %.

Here we report the case of a 50-year-old immunocompetent woman, with no known comorbidities and no recent surgical history. She was initially diagnosed with a perineal abscess; however, after the infection worsened, she was later diagnosed with Meleney's synergistic gangrene. Immediate extensive debridement was performed, and empirical intravenous antibiotics were administered. Shortly after the procedure, and before regaining consciousness, the patient's condition rapidly deteriorated, and she succumbed to death.

Early identification of Meleney's gangrene, followed by prompt treatment with broad-spectrum antibiotics and aggressive surgical debridement, is essential for improving outcomes. However, early diagnosis is often challenging, and considerable uncertainty may complicate the process. A delayed diagnosis of Meleney's gangrene significantly increases the risk of mortality.

This case is reported to highlight how delayed diagnosis and late intervention can result in a fatal outcome in cases of Meleney's gangrene. Effective treatment can be implemented only if early diagnosis of this rare form of gangrene is achieved.