Pre and retroperitoneal necrotizing fasciitis after COVID-19 infection: A case report

Abstract

Necrotizing fasciitis is a serious infection that originates in the subcutaneous tissues. We present a case of 52 years old male patient who developed preperitoneal and retroperitoneal necrotizing fasciitis 2 weeks after the start of Coronavirus-19 infection. Preoperative abdominal computed tomography with intravenous and oral contrast revealed pre and retroperitoneal spread of air loculi with turbid fluid patches within necrotic tissues. After surgical excision of the lesion, histopathological and microbiological examinations of the samples revealed necrotizing fasciitis. This is the first report of preperitoneal and retroperitoneal necrotizing fasciitis after Coronavirus-19 infection in 52 years old male with no history of trauma or immunocompromised condition. Coronavirus-19 infection may increase the liability of patients to develop overwhelming infection and it may also delay the patient presentation causing serious health-related emergencies. The findings of necrotizing fasciitis on clinical grounds or imaging studies can help in diagnosis as well as the surgical intervention and appropriate antibiotics can highly impact the prognosis and survival of the patient.

Retroperitoneal necrotizing soft tissue infections: A case report and literature review

“…Regarding the mortality, four of the 14 patients died while the rest were able to be discharged to home or rehabilitation centers. The details of the cases are elucidated in Table 1 8–20 . It is worth noting that six of the patients reported having abscess drainage along with debridement for necrotizing soft tissue infection, so may not have strictly fulfilled the diagnostic criteria.…”

“…The details of the cases are elucidated in Table 1. [8][9][10][11][12][13][14][15][16][17][18][19][20] It is worth noting that six of the patients reported having abscess drainage along with debridement for necrotizing soft tissue infection, so may not have strictly fulfilled the diagnostic criteria. In addition, the low mortality rate we have gathered may have been a subject of bias in publication of successfully managed cases only by authors and not a reflection of a real-world mortality rate of the condition.…”

“…Extensive literature review showed 14 cases of retroperitoneal necrotizing soft tissue infections from 13 case reports and one case series. [8][9][10][11][12][13][14][15][16][17][18][19][20] The age of the patients ranged from 21 to 67 years with mean age of 48 years of age. Males were predominant with 11 of the 14 reported cases.…”

Extensive monomicrobial necrotizing fasciitis and myonecrosis of left hemi trunk in a healthy 41-year-old man with COVID-19 infection

“…Underlying coronavirus infection 19 (COVID-19) may increase the risk of secondary infections, including necrotizing fasciitis, and may affect its treatment ( 5 ). Clinical manifestations of necrotizing fasciitis show a range of symptoms; hence timely diagnosis and treatment is a significant challenge ( 6 ).…”

Skin necrosis in COVID-19 patients: complication of therapy or one of clinical and pathological mechanisms of viral infection?

“…43,44 It is a bacterial infection caused by multiple microorganisms such as group A Streptococcus, Staphylococci, Clostridium perfringens, and anaerobic strains (Escherichia coli, Bacteroides fragilis). Bacteria multiply and produce toxins and enzymes that cause thrombosis in blood vessels.CONCLUSIONSCutaneous necrosis in COVID-19 patients during the pandemic period, according to this review, is not rare.…”