Necrotizing Fasciitis

SavageGlow · #1 ● 05-09-2024, 11:59 PM

>>A female patient 60 years old, obese (high 161 cm, weight 114 kg, BMI = 44), mother of five children, diabetic, had raised temperature, inflammatory changes in the area of groins and light pains in this area, which lasted in the past 3 days.

>>During the examination, a surgeon made the diagnosis of excessive body weight, hanging stomach, erythema and cellulites beside minimal sore spots of the bent and hanging bottom of abdomen. Furthermore, he recommended antibiotic therapy and directed the patient to the dermatologist. Two days after she was examined by the dermatologist who described the skin erythema of abdominal wall and groins, which were warm and milder painful sensitive.

>>Because of the general plight, the patient was hospitalized at the Internal Clinic, and the same day was moved to the Department of Nephrology, under the diagnosis of abdominal walls phlegmona. At the admittance the patient was conscious, febrile 38,4°C with the expressed erythema of wall of lower half abdomen and groins, with skin bullae filled with yellowish liquid contents. At the admittance sedimentation was 132, and leukocytes 8,23 x 109 / l. From urinoculture were isolated Escherichia coli and hemocultures were sterile. Daily doses of combined Tazocin 4 x 2,25 g and Diflucan a 100 mg were administered. Anemia was corrected with transfusions. During the hospitalization at the Internal Clinic, on a few occasions, the patient was examined by the surgeon when necrectomy and incisions were done. Microbiologically, Staphylococcus epidermidis was isolated from wound svab.

>>In spite of intensive antibiotic therapy, inflammatory and necrotic progression occurred and patient was moved to the Surgical Clinic until she died 3 months later.