Necrotizing Fasciitis: A Rare Case

Abstract

Necrotizing fasciitis is a life threatening soft-tissue infection characterized by progressive necrosis of skin, subcutaneous tissues and fasciae. Morbidity and mortality rates are high despite early diagnosis and treatment. An eleven year-old male patient presented to our emergency service with swelling and pain on his left arm; both set on the day before. Physical examination revealed swelling, heat and pain related to passive movement; erythema was absent. During follow-up, area involved developed echymotic bullous lesions; which shortly spread to the lateral chest wall. Although appropriate antibiotherapy and supportive management, lesions progressed and the patient deceased due to septic shock on the second day of his admission. The culture of the aspirate of the bullae revealed Streptococcus pyogenes. Although it can occasionally be encountered on completely healthy individuals, necrotizing fasciitis is more likely occur along with predisposing factors such as trauma, surgical intervention, systemic disorders, chicken pox, insect bites, immune compromising situations, and parenteral drug use. Although there are no reports concerning increased risk of necrotizing fasciitis in the presence of cutis laxae, we report a case of fatal necrotising fasciitis in an individual who was diagnosed cutis laxae.