Necrotising fasciitis of the thoracic wall: a rare case with favourable outcome

Abstract

Necrotising fasciitis (NF) is a severe infection of the subcutaneous tissue and fascia that can rapidly lead to sepsis and shock with high mortality rates. Its initial signs are often non-specific making it difficult for an early diagnosis to be reached. Nevertheless it is of the utmost importance to begin proper treatment including wide surgical debridement as soon as possible in order to avoid death. We present the case of a patient with NF of the thoracic wall which is a rare location for this disease but often associated with worse prognosis. Even though he progressed to septic shock within less than 24 hours of its presentation, due to early surgical management, aggressive resuscitation and intensive care support, he reached a favourable outcome. After three surgical revisions and 2 weeks in an intensive care unit, the patient was discharged from hospital 35 days after admission.

Rectogluteal fistula presenting as necrotising myofasciitis of the gluteal region

“…It can also be classified based on the anatomic location that is affected. This includes the head and neck region (Ludwig angina), the thoracic region, the abdominal region (Meleney’s gangrene) and the pelvic region (Fournier’s gangrene) 14 15. Fournier’s gangrene is particularly severe and historically can have mortalities up to 20%–80% reported in the literature 16.…”