A rare and fatal cause of right iliac fossa pain—When retroperitoneal necrotizing fasciitis masquerades as acute appendicitis: A case report and review of recent reported cases

Abstract

Introduction: Retroperitoneal necrotizing fasciitis is an uncommon, rapidly fatal condition which often mimics other diseases. Case presentation: We report a case of an elderly woman who was referred to our Emergency Department for suspected acute appendicitis. Computed tomography scan showed an iliopsoas abscess with necrotizing fasciitis on computed tomography scan. Despite aggressive surgical treatment and early antibiotics, she passed away 3 weeks later. Conclusion: Such a case has rarely been reported in an immunocompetent patient who has had no instrumentation, surgeries, or trauma. It serves to highlight the difficulty in diagnosing retroperitoneal necrotizing fasciitis, especially in the elderly patient, as well as the need to recognize it early in the Emergency Department.