Postoperative necrotizing chest-wall infection. Case report of a rare complication after elective lung surgery

Necrotizing fasciitis, an uncommon, often fulminant bacterial infection, rarely originates in the chest wall. In a 67-year-old woman, elective lower lobectomy of the right lung was followed by fatal necrotizing fasciitis of the chest wall. Tissue necrosis and overwhelming sepsis were due to synergistic infection by Staphylococcus aureus and Streptococcus microaerophilica. As the early appearance of necrotizing fasciitis is deceptively benign, the diagnosis is extremely difficult and is reliant on a high index of suspicion. Prompt surgical intervention is essential.