Necrotising fasciitis

Case contributed by Dr Vijay Mistry

Presentation

Rapid progressive swelling of the right forearm.

Patient Data

Age: 60 years
Gender: Male
X-ray

Extensive soft tissue gas involving the right hand and visualised right forearm.

X-ray

Surgical staples along the lateral aspect of the distal forearm and hand consistent with previous debridement. Soft tissue swelling. Amputation of the 1st and second digits from the level of the mid shaft first phalanx and mid shaft of 2nd metacarpal.

Case Discussion

A case of necrotising fasciitis presenting as rapidly progressive right arm swelling and pain after sustaining a laceration to right arm. Multiple debridements confirmed Clostridium septicum, with amputation of right thumb and index finger and flap reconstruction performed. This highlights the importance of obtaining plain radiographs when working up certain cases of soft tissue infections.

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Case information

rID: 56961
Case created: 30th Nov 2017
Last edited: 2nd Dec 2017
Inclusion in quiz mode: Included
Institution: Princess Alexandra Hospital

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