Case Report

Case Report of Rare Necrotizing Fasciitis with Pseudomonas in a Healthy Infant

Abstract

Necrotizing fasciitis is a rare and lethal bacterial infection of the subcutaneous tissue and fascia in pediatrics, particularly when Pseudomonas Aeruginosa is involved. The similarity between cellulitis and Necrotizing fasciitis can lead to misdiagnosis. A 5-month-old male is introduced, presenting with fever and ecchymoses on his left thigh, which was treated as cellulitis. However, the diagnosis was changed to necrotizing fasciitis due to rapid progression in infection and pseudomonas growth in cultures. The antibiotics were leveled up, and the surgeon debrided and grafted the skin. Finally, the patient was discharged in good condition. In the early stages of soft tissue infections, it is not possible to distinguish Necrotizing fasciitis from cellulitis, so empirical antibiotics should be started to cover poly-microbial infections, and the patient should be observed closely. When the infection does not respond to the antibiotics appropriately over 24 hours, the surgeon.

[1] Goh T, Goh LG, Ang CH, Wong CH. Early diagnosis of necrotizing fasciitis. Br J Surg. 2013. https://doi.org/10.1002/bjs.9371
[2] Miguel F, Acevedo A, Cervantes YH, Victor G, Ketemepi D, Lopez DM. Cervicofacial necrotizing fasciitis after topical application of herbal medicine. J Surg Case Rep. 2021;11:1-5. https://doi. org/10.1093/jscr/rjab481
[3] Fustes-morales A, Gutierrez-castrellon P, Duran-mckinster C, Orozco-covarrubias L, Tamayo-sanchez L, Ruiz-maldonado R. Necrotizing Fasciitis. Arch Dermatol. 2002;138:893-9. https:// doi.org/10.1001/archderm.138.7.893
[4] Pfeifle VA, Gros SJ, Holland-Cunz S, Kämpfen A. Necrotizing fas- ciitis in children due to minor lesions. J Pediatr Surg Case Rep. 2017;25:52-5. https://doi.org/10.1016/j.epsc.2017.08.005
[5]Farah R, Asla H. Necrotizing Fasciitis of the Chest Wall. Harefuah. 2016;155:656-60. https://doi.org/10.1097/ PEC.0000000000000316
[6] Zundel S, Lemaréchal A, Kaiser P, Szavay P. Diagnosis and Treatment of Pediatric Necrotizing Fasciitis: A Systematic Re- view of the Literature. Eur J Pediatr Surg. 2017;27:127-37. https://doi.org/10.1055/s-0036-1584531
[7] Cheung JPY, Fung B, Tang WM, Ip WY. A review of necrotising fasciitis in the extremities. Hong Kong Med J. 2009;15:44-52.
[8] Saz EU, Anik A, Tanriverdi HI, Anik A, Ergün O. Pseudomonas necrotizing fasciitis following an intramuscular injection in an immunocompetent child. Pediatr Int. 2010;52. https://doi. org/10.1111/j.1442-200X.2010.03055.x
[9] Mercier G, Parrado RH, Jenkins DSC. Use of a Dermal Ma- trix for an Open Chest Wound in a Newborn with Com- plicated Necrotizing Fasciitis. Am Surg. 2021. https://doi.org/10.1177/00031348211054549
[10] Bayard IPE, Grobbelaar AO, Constantinescu MA. Necrotizing fasciitis caused by mono-bacterial gram-negative infection with E.coli - the deadliest of them all: A case series and review of the literature.JPRAS Open [Internet]. 2021;29:99-105. https://doi.org/10.1016/j.jpra.2021.04.007
[11] Hsieh WS, Yang PH, Chao HC, Lai JY.Neonatal necrotizing fas- ciitis: a report of three cases and review of the literature.Pe- diatrics [Internet].1999;103(4):4-11. https://doi.org/10.1542/peds.103.4.e53
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IssueVol 8 No 3 (2023): May-June QRcode
SectionCase Report(s)
DOI https://doi.org/10.18502/crcp.v8i3.14234
Keywords
Necrotizing Fasciitis Pseudomonas Cellulitis

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How to Cite
1.
khodabandeh mahmood, afshoon maryam. Case Report of Rare Necrotizing Fasciitis with Pseudomonas in a Healthy Infant. CRCP. 2023;8(3):104-107.