Necrotizing Fasciitis Associated With Toxic Shock Syndrome.

Division

East Florida

Hospital

Westside Regional Medical Center

Document Type

Case Report

Publication Date

3-8-2024

Keywords

debridement, group a strep, lrinec score, modified lrinec score, necrotising fasciitis, necrotizing fasciitis; necrotizing fasciitis with toxic shock syndrome, septic shock, streptococcus pyogenes, toxic shock syndrome

Disciplines

Bacterial Infections and Mycoses | Internal Medicine | Medicine and Health Sciences | Pathological Conditions, Signs and Symptoms

Abstract

Necrotizing fasciitis is a rapidly progressing bacterial infection that affects the deep fascia and subcutaneous tissues, often resulting in tissue necrosis and systemic toxicity. This case involves a male in his late forties who initially sought emergency care for a minor rash on his right lower extremity and symptoms of a viral illness. Despite an initial diagnosis of hematoma, his symptoms rapidly escalated within 24 hours, prompting his return to the emergency room. During this subsequent visit, signs of septic shock emerged, accompanied by a worsening rash and blister formation. Admitted to the intensive care unit, our patient received urgent treatment, including broad-spectrum antibiotics and surgical debridement based on the Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score for assessing necrotizing fasciitis severity. Further debridement and a fasciotomy were performed, leading to improved clinical conditions, stabilized vitals, and normalized laboratory results. This case underscores the critical importance of early clinical suspicion, prompt diagnosis, and a collaborative, team-based approach in successfully managing necrotizing fasciitis.

Publisher or Conference

Cureus

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