From Skin Deep to Life-Threatening: A Case of Necrotizing Fasciitis Masquerading as Ecchymosis.

Division

North Florida

Hospital

Osceola Regional Medical Center

Document Type

Case Report

Publication Date

7-1-2025

Keywords

diabetic wound, lrinec score, necrotizing fasciitis, necrotizing skin and soft tissue infections, sepsis, staphylococcus-associated glomerulonephritis

Disciplines

Bacterial Infections and Mycoses | Emergency Medicine | Medicine and Health Sciences

Abstract

Necrotizing fasciitis (NF) is a rare but life-threatening infection characterized by rapid and extensive tissue necrosis. Early identification is often difficult, particularly when physical exam findings are subtle or atypical. We present the case of a man in his forties with poorly controlled type 2 diabetes mellitus who arrived at the emergency department after noticing discoloration and swelling of his right great toe. The patient had minimal pain but was noted to be hypotensive and tachycardic on arrival. Laboratory workup revealed hyperglycemia, hyponatremia, and elevated lactic acid. Imaging was negative for fracture or subcutaneous air. Due to the rapid progression of symptoms and abnormal vital signs, general surgery was consulted to evaluate for NF. The patient was admitted and subsequently developed a temperature of 106°F, requiring escalation of care. He underwent surgical debridement and amputation of the right hallux. Wound and blood cultures grew

Publisher or Conference

Cureus

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