Necrotising fasciitis

Case contributed by Dr Domenico Nicoletti

Presentation

Admitted to hospital because of a severe and persistent bilateral and inguinal pains, radiating to both legs, lasting from 6 hours. On admission patient was afebrile, alert and oriented. Blood tests were mioglobin 17204ug/L (reference <72) and aspartate transaminasis 1810 U/I (reference <40). The renal function and electrolytes were within normal range.

Patient Data

Age: 51
Gender: Male
MRI

Preliminary abdomen CT (not uploaded) scan showed hepatomegaly and splenomegaly, with hypertrophy of iliopsoas and left medius gluteus muscles, along with a subcutaneous hyperdensity in the left buttock.

MRI showed an interstital oedema of the iliopsoas muscles, while, in the pelvis, bilateral oedema of the adipose tissue was present without any fluid level.

Case Discussion

Necrotising fasciitis by Streptococcus equi zooepidemicus.

Necrotising soft tissue infections include necrotising forms of cellulitis, myositis, and fasciitis. These infections are characterised clinically by fulminant tissue destruction, systemic signs of toxicity, and high mortality. Accurate diagnosis and appropriate treatment must include early surgical intervention and antibiotic therapy.

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Case information

rID: 27552
Case created: 7th Feb 2014
Last edited: 17th Sep 2015
Inclusion in quiz mode: Included

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