Perianal Necrotizing Fasciitis with Retroperitoneal Extension: A Case Report from Pakistan

Abstract

Necrotizing fasciitis is a rare but potentially fatal condition. It is defined as a rapidly spreading infection of the subcutaneous soft tissue. Extension into the retroperitoneum may further complicate this deadly condition. We report a case of a 45-year-old gentleman who presented to our institute with perianal necrotizing fasciitis with extension into the retroperitoneum. He was managed with antibiotics and prompt surgical debridement. Our patient had a positive outcome which may be due to the fact that we had a high clinical suspicion, on the basis of which we opted for early operative management rather than delaying definitive treatment by obtaining imaging.

Necrotizing fasciitis of cryptoglandular infection treated with multiple incisions and thread-dragging therapy: A case report

“…What’s more, the key to cure necrotizing fasciitis is timely and thoroughly debriding the affected area[ 9 ]. The reason why we performed surgery immediately after the patient’s admission was based on the symptoms and examination findings, which surely confirmed the diagnosis.…”

Retroperitoneal necrotizing fasciitis with the involvement of the anterior abdominal wall following perianal abscess

“…Both aerobic and anaerobic bacteria alone or in synergism and fungal species have been identified as the causative agents in NF [ 4 , 7 ]. Although NF can occur in the absence of clinical risk factors [ 5 , 6 ], older age, diabetes mellitus, obesity, cancers and autoimmune disorders are identified clinical risk factors [ 2–5 ].…”

“…The clinical feature common to all types of NF is agonizing pain, quite out of proportion with few local clinical signs [ 2 , 7 ]. In the absence of an early diagnosis, resuscitation and surgical management, mortality from NF ranges from 8.7 to 73% [ 2 , 3 , 9 ] with recent literature reporting a lesser rate of mortality around 26-32% [ 4 , 5 ].…”