Delayed diagnosis and management of necrotizing fasciitis of the left lower leg: A case report

Abstract

Introduction: Necrotizing fasciitis (NF) is a rare, severe soft tissue infection, characterized by rapid and extensive necrosis of the skin, subcutaneous tissue, and superficial and deep fascia. It is frequently misdiagnosed as other infectious diseases, leading to inappropriate treatment and potentially serious consequences. It may be complicated by septic shock and multiple organ failure with a fatal outcome.Patient concerns: A 73-year-old woman presented with continuous itching, skin lesions, pain, and swelling of the outer side of her left leg. The patient was diagnosed with septic shock and multiorgan failure caused by left leg NF.Diagnosis: Septic shock and multiorgan failure caused by left leg NF.Interventions: Two surgeries were performed on the patient's leg, which effectively treated her septic shock and multiple organ dysfunction.Outcomes: The patient was followed up three times after her discharge. She had a good recovery, was generally well with no significant sequelae, and returned to her regular life. Conclusion:NF is an acute severe illness with high mortality. It is easily misdiagnosed, leading to delayed or erroneous treatment and serious (or potentially fatal) outcomes. Rapid and accurate diagnosis of NF is essential for patient recovery. In difficult cases, multidisciplinary consultations may be helpful. The management of NF includes early and thorough surgical debridement, antibiotics, and symptomatic treatment.

An Overview of Clinical Manifestations of Dermatological Disorders in Intensive Care Units: What Should Intensivists Be Aware of?

“…However, surgical debridement with microbiological and histopathological examination of soft tissue is the gold standard action for both diagnosis and treatment. Aerobic coverage with ampicillin–sulbactam or carbapenems should be combined with anaerobic coverage with metronidazole or clindamycin [ 48 , 49 ].…”

Phytoconstituent-Loaded Nanofibrous Meshes as Wound Dressings: A Concise Review

“…Some chronic wounds can take up to 12 weeks to heal [13,14]. Ulcers result from prolonged illness, repetitive trauma to the tissues, and delayed treatment [15,16] to these wounds. The presence of anoxia, hypoxia, lesions, cell debris, and systemic barriers all play a role in the development of chronic wounds [17].…”