Necrotizing Fasciitis Causing Complete Femoral Vessels Necrosis and Thrombosis in an Intravenous Drug Abuser: A Case Report

Background: Intravenous drug abuse is an anciently known health and social problem worldwide. The nonsterile application of addicting drugs leads to severe life-threatening vascular complications. The femoral triangle is an easy target for this purpose. Groin necrotic fasciitis (NF) with vessel necrosis is a challenging diagnosis that requires prompt treatment. Case Report: A 44-year-old male intravenous drug user presented for a left groin pain. He was diagnosed by computed tomography scan to have necrotizing fasciitis. Urgent debridement was performed and identified infected and necrotic ruptured femoral vessels without active bleeding. Debridement with vessel ligation was performed, and delayed revascularization was planned. The patient was admitted six weeks later with a left fifth toe necrosis and delayed arterial revascularization was performed via extra-anatomic trans-obturator ilio-femoral anastomosis. The patient had a favorable follow-up. Conclusion: NF in intravenous drug abusers should always be taken into consideration when a patient presents with groin pain and swelling. Urgent surgical control should be established. Extra-anatomical trans-obturator ilio-femoral anastomosis is a good option for revascularization.

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Necrotizing Fasciitis Occurred in the Lymphedematous leg

The International Journal of Lower Extremity Wounds ◽

10.1177/15347346211023030 ◽

2021 ◽

pp. 153473462110230

Author(s):

Hisako Hara ◽

Makoto Mihara ◽

Takeshi Todokoro

Keyword(s):

Case Report ◽

Necrotizing Fasciitis ◽

Lower Limb ◽

Gynecologic Cancer ◽

Vital Signs ◽

Ethics Committee ◽

Secondary Lymphedema ◽

Delayed Treatment ◽

Institutional Ethics ◽

Life Threatening

Lymphedema is a chronic edema that sometimes occurs after treatment of gynecologic cancer, and cellulitis often occurs concomitantly with lymphedema. On the other hand, necrotizing fasciitis (NF) is a relatively rare, but life-threatening disease. The symptoms in cellulitis and NF are very similar. In this case report, we describe a case in which the diagnosis of NF in a lymphedematous limb was difficult. A 70-year-old woman had secondary lymphedema in bilateral legs and consulted our department. On the first day of lymphedema therapy, the patient complained of vomiting, diarrhea, and fever (37.7 °C) without local fever in the legs. She was diagnosed with acute gastroenteritis. On the next day, swelling and pain in her left leg occurred and her blood pressure was 59/44 mmHg. She was diagnosed with cellulitis accompanied by lower limb lymphedema and septic shock. On the second day, blisters appeared on the left leg, and computed tomography showed NF. We performed debridement under general anesthesia and her vital signs improved postoperatively. Streptococcus agalactiae (B) was detected in blood culture, and we administered bixillin and clindamycin. Postoperatively, necrosis in the skin and fat around the left ankle gradually spread, and it took 5 months to complete epithelialization. The diagnosis was more difficult than usual NF because patients with lymphedema often experience cellulitis. Clinicians should always think of NF to avoid mortality due to delayed treatment. This case report was approved by the institutional ethics committee.

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Necrotizing fasciitis with prior leprosy: a case report

International Journal of Research in Dermatology ◽

10.18203/issn.2455-4529.intjresdermatol20204568 ◽

2020 ◽

Vol 6 (6) ◽

pp. 788

Author(s):

Vannia C. Teng ◽

Prima K. Esti ◽

Sweety Pribadi

Keyword(s):

Case Report ◽

Necrotizing Fasciitis ◽

Limited Resource ◽

Masking Effect ◽

Risk Indicator ◽

Broad Spectrum Antibiotic ◽

Life Threatening ◽

Lrinec Score ◽

Improve Patient Management ◽

Improve Patient

<p class="abstract">Necrotizing fasciitis (NF) is a life-threatening soft tissue infection with a high misdiagnosis rate. Here, we present the case of NF with hypoesthesia due to prior leprosy in a limited resource area. Laboratory risk indicator for NF (LRINEC) score was used to determine the diagnosis of NF. Resuscitation and broad-spectrum antibiotic were initiated, followed by surgical debridement due to lack of wound improvement and skin graft to cover the wound was done. This case report highlights the usage of LRINEC score to reduce misdiagnosis, ensure early diagnosis, and improve patient management in NF with masking effect.</p>

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Intramedullary Spinal Cord Abscess

Neurosurgery ◽

10.1227/00006123-199001000-00023 ◽

1990 ◽

Vol 26 (1) ◽

pp. 145-146 ◽

Cited By ~ 33

Author(s):

Barbara S. Koppel ◽

Michael Daras ◽

Kent R. Duffy

Keyword(s):

Spinal Cord ◽

Intravenous Drug User ◽

Intravenous Drug ◽

Drug Abusers ◽

Pseudomonas Cepacia ◽

Intramedullary Spinal Cord ◽

Intramedullary Abscess ◽

History Of ◽

Intramedullary Spinal Cord Abscess ◽

High Index Of Suspicion

Abstract Viral myelitis and bacterial epidural infections are common in intravenous drug abusers, but primary infections of the spinal cord are extremely rare. We report a 50-year-old active intravenous drug user who developed tetraplegia from an intramedullary abscess caused by Pseudomonas cepacia. Despite neurosurgical drainage and appropriate antibiotic therapy, no improvement was seen. Earlier intervention and a high index of suspicion is required in patients with a history of intravenous drug abuse and spinal cord symptoms. (Neurosurgery 26:145-146, 1990)

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Case Report of Necrotizing Fasciitis Associated withStreptococcus pneumoniae

Canadian Journal of Infectious Diseases and Medical Microbiology ◽

10.1155/2016/6872739 ◽

2016 ◽

Vol 2016 ◽

pp. 1-4 ◽

Cited By ~ 3

Author(s):

Lei Jiao ◽

Zain Chagla ◽

Reham Mohammedsaeed Kaki ◽

Gabriela Gohla ◽

Marek Smieja

Keyword(s):

Case Report ◽

Streptococcus Pneumoniae ◽

Necrotizing Fasciitis ◽

Neutrophil Infiltration ◽

Skin Lesions ◽

Blood Samples ◽

Surgical Exploration ◽

Lower Back ◽

Life Threatening ◽

The Right

Necrotizing fasciitis, caused byStreptococcus pneumoniae, is an extremely rare and life-threatening bacterial soft tissue infection. We report a case of early necrotizing fasciitis associated withStreptococcus pneumoniaeinfection in a 26-year-old man who was immunocompromised with mixed connective tissue disease. The patient presented with acute, painful, erythematous, and edematous skin lesions of his right lower back, which rapidly progressed to the right knee. The patient underwent surgical exploration, and a diagnosis of necrotizing fasciitis was confirmed by pathological evidence of necrosis of the fascia and neutrophil infiltration in tissue biopsies. Cultures of fascial tissue biopsies and blood samples were positive forStreptococcus pneumoniae. To our knowledge, this is the first report of necrotizing fasciitis resulting fromStreptococcus pneumoniaediagnosed at early phase; the patient recovered well without surgical debridement.

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