Necrotising fascitis - a life-threatening infection: Case reports and literature review

Abstract

Introduction. Necrotizing fasciitis is a rare, severe, aggressive infection, life-threatening surgical emergency that spreads quickly, characterized by extensive necrosis of the deep and superficial fascia, associated with significant morbidity and mortality. Case outline. We are presenting two case reports with necrotizing fasciitis: a 54-year-old male patient, obese, with hypertension and untreated perianal fistula with severe infection of perianal region, perineum and scrotum, and a 64-year-old female patient with diabetes mellitus and heart disease, with severe infection of the lower extremity, anterior abdominal wall, inguinal and gluteal region, in which the entry point of infection were microlesions of the skin after shaving. Both patients were treated by emergency extensive surgical necrectomy with eradication of the deep infection source, with all conservative treatment measures. One patient was treated with hyperbaric oxygen therapy, the other was not because of cardiac and pulmonary contraindications. Conclusion. Better treatment outcome requires a multidisciplinary approach (cardiologist, endocrinologist, nephrologist, orthopedist, surgeon). Rapid and extensive surgical necrectomy is necessary to increase the success of the treatment of patients with this infection.