Necrotizing 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, the patient was afebrile, alert and oriented. Blood tests were myoglobin 17204ug/L (reference <72) and aspartate transaminasis 1810 U/I (reference <40). The renal function and electrolytes were within normal range.

Patient Data

Age: 50 years
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 edema of the iliopsoas muscles, while, in the pelvis, bilateral edema of the adipose tissue was present without any fluid level.

Case Discussion

Necrotizing fasciitis by Streptococcus equi zooepidemicus.

Necrotizing soft tissue infections include necrotizing forms of cellulitis, myositis, and fasciitis. These infections are characterized 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
Published: 12th Feb 2014
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included

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