Keywords
sepsis
infectious diseases
herpes zoster
diabetes mellitus
corticosteroid therapy
How to Cite
Abstract
Introduction: Fasciitis is an inflammation of the fascia, the connective tissue that surrounds muscles, blood vessels, and nerves, which can rapidly progress to necrosis of these structures, leading to life-threatening situations. It is a polymicrobial infection caused by bacterial agents, fungi, viruses, and parasites, resulting in septicemia, multiorgan failure, septic shock, and potentially death. The LRINEC score is a valuable tool in diagnosing necrotizing fasciitis (NF).
Case Presentation: The patient is a 62-year-old woman with a history of Diabetes Mellitus type 2 and Bilinear Myelodysplasia, currently receiving high-dose corticosteroid therapy. She was recently diagnosed with Herpes Zoster affecting the S1, S2, S3, S4, and S5 dermatomes. Initially, she was treated for 8 days with antivirals and antibiotics for symptoms of fever, fatigue, and pain in the gluteal and lumbar regions. However, her condition worsened, prompting her readmission to the hospital, where she developed signs of sepsis. After imaging, laboratory tests, and consultations with surgeons, she was diagnosed with necrotizing fasciitis. Multidisciplinary management and complex therapy led to an excellent outcome.
Conclusion: Necrotizing fasciitis presents a significant diagnostic challenge due to its rarity and its clinical resemblance to other critical conditions. It is an urgent pathology that requires not only surgical intervention but also immediate medical attention. It has always intrigued healthcare professionals both locally and internationally. Early diagnosis remains the primary challenge, and the management of these patients by experienced senior surgeons is crucial for successful outcomes.
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