Necrotising fasciitis

Case contributed by Dr Ian Bickle

Presentation

This female patient with known lung cancer, under treatment in the cancer hospital, had a rapidly enlarging soft tissue abnormality on her left thigh

Patient Data

Age: 70
Gender: Female

12 hours following the film shown the patient passed away

Modality: X-ray

Extensive linear lucencies in the left hemipelvis and thigh, in keeping with air tracking through the fascial planes.

Case Discussion

Necrotizing fasciitis is a rapidly progressive inflammatory infection of the fascia, with secondary involvement of the subcutaneous tissues. Necrotizing fasciitis tracks along the fascial plane, often at an alarming speed. The causative bacteria may be aerobic, anaerobic, or as is now recognized typically a mixed flora of micro-organisms. Organisms spread from the subcutaneous tissue through the superficial and deep fascial planes, thought to be facilitated by bacterial enzymes and toxins. The deeper infection then causes vascular occlusion, ischemia, and tissue necrosis. The incidence of necrotizing fasciitis is increasing due to the higher number of immuno-compromised patients under medical care.

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Case Information

rID: 19317
Case created: 27th Aug 2012
Last edited: 4th Feb 2016
Inclusion in quiz mode: Included

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