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Abstract
Necrotizing fasciitis is a severe soft tissue infection characterized by rapidly progressing necrosis of subcutaneous tissues. This rare condition carries a high mortality rate and requires prompt diagnosis and urgent treatment with radical aggressive surgical debridement and targeted antibiotics. We report the case of a 5-year old girl referred to our service of paediatric surgery with necrotizing fasciitis of the right leg following a peripheral vein infusion of quinine at a peripheral health Centre. The case is a reminder that severe life and limb threatening infection such as necrotizing fasciitis can result from simple procedures such as peripheral venous access. This underscores the importance of strict adherence to aseptic measures in all, especially invasive medical procedures.
RÉSUMÉ
La fasciite nécrosante est une infection des tissus mous sévère caractérisée par la progression rapide de nécrose, impliquant les tissues hypodermites. Cette affection rare porte un taux de mortalité élevé et nécessite un diagnostic rapide et un traitement urgent avec débridement chirurgical agressif radical et des antibiotiques. Nous avons décrit un cas d'une fille de 5 ans qui a été transférée à notre service de chirurgie pédiatre pour fasciite nécrosante de la jambe droite suite à une perfusion intraveineuse de quinine dans une veine périphérique sur la jambe dans un centre de santé. Le cas est un rappel que des infections sévères telles que la la fasciite nécrosante peuvent résulter de procédures simples telles que l'accès veineux périphérique. Il met en évidence la nécessité d'asepsie dans toutes les procédures médicales.
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References
- References
- Puvanendran R, Huey JCM, Pasupathy S. Necrotizing fasciitis. Can Fam Physician Médecin Fam Can. 2009;55(10):981–7.
- Naqvi G, Malik S, Jan W. Necrotizing Fasciitis of the lower extremity: a case report and current concept of diagnosis and management. Scand J Trauma Resusc Emerg Med. 2009 ;17:28.
- Sadasivan J, Maroju NK, Balasubramaniam A. Necrotizing Fasciitis. Indian J Plast Surg Off Publ Assoc Plast Surg India. 2013;46(3):472–8.
- Giuliano A, Lewis F, Hadley K, Blaisdell FW. Bacteriology of necrotizing fasciitis. Am J Surg. 1977;134(1):52–7.
- Sikora CA, Spielman J, MacDonald K, Tyrrell GJ, Embil JM. Necrotizing fasciitis resulting from human bites: A report of two cases of disease caused by group A streptococcus. Can J Infect Dis Med Microbiol. 2005;16(4):221–4.
- Choi M-G. Necrotizing fasciitis of the head and neck: a case report. J Korean Assoc Oral Maxillofac Surg. 2015;41(2):90–6.
- Green RJ, Dafoe DC, Raffin TA. NEcrotizing fasciitis. Chest. 1996 Jul 1;110(1):219–29.
- Wong C-H, Chang H-C, Pasupathy S, Khin L-W, Tan J-L, Low C-O. Necrotizing fasciitis: clinical presentation, microbiology, and determinants of mortality. J Bone Joint Surg Am. 2003 Aug;85-A(8):1454–60.
- Hefny AF, Eid HO, Al-Hussona M, Idris KM, Abu-Zidan FM. Necrotizing fasciitis: a challenging diagnosis. Eur J Emerg Med Off J Eur Soc Emerg Med. 2007;14(1):50–2.
- Voros D, Pissiotis C, Georgantas D, Katsaragakis S, Antoniou S, Papadimitriou J. Role of early and extensive surgery in the treatment of severe necrotizing soft tissue infection. Br J Surg. 1993;80(9):1190–1.
- Lakshmanan MC, Hershey CO, Breslau D. Hospital admissions caused by iatrogenic disease. Arch Intern Med. 1986;146(10):1931–4.
- Leibig N, Hirche C, Schmidt VJ, Bigdeli AK, Kneser U, Kremer T. Necrotizing fasciitis after central venous catheter placement. Surg Infect. 2014 Dec;15(6):850–2.
- Bisno AL, Stevens DL. Streptococcal Infections of Skin and Soft Tissues. N Engl J Med. 1996;334(4):240–6.
- Alsharari M, Pasquesoone L, Khater R, Guerreschi P, De Broucker V, Martinot-Duquennoy V. Necrotizing soft tissue infections following a scald burn of the lower limb: a case report. Ann Burns Fire Disasters. 2013;26(3):158–61.
References
References
Puvanendran R, Huey JCM, Pasupathy S. Necrotizing fasciitis. Can Fam Physician Médecin Fam Can. 2009;55(10):981–7.
Naqvi G, Malik S, Jan W. Necrotizing Fasciitis of the lower extremity: a case report and current concept of diagnosis and management. Scand J Trauma Resusc Emerg Med. 2009 ;17:28.
Sadasivan J, Maroju NK, Balasubramaniam A. Necrotizing Fasciitis. Indian J Plast Surg Off Publ Assoc Plast Surg India. 2013;46(3):472–8.
Giuliano A, Lewis F, Hadley K, Blaisdell FW. Bacteriology of necrotizing fasciitis. Am J Surg. 1977;134(1):52–7.
Sikora CA, Spielman J, MacDonald K, Tyrrell GJ, Embil JM. Necrotizing fasciitis resulting from human bites: A report of two cases of disease caused by group A streptococcus. Can J Infect Dis Med Microbiol. 2005;16(4):221–4.
Choi M-G. Necrotizing fasciitis of the head and neck: a case report. J Korean Assoc Oral Maxillofac Surg. 2015;41(2):90–6.
Green RJ, Dafoe DC, Raffin TA. NEcrotizing fasciitis. Chest. 1996 Jul 1;110(1):219–29.
Wong C-H, Chang H-C, Pasupathy S, Khin L-W, Tan J-L, Low C-O. Necrotizing fasciitis: clinical presentation, microbiology, and determinants of mortality. J Bone Joint Surg Am. 2003 Aug;85-A(8):1454–60.
Hefny AF, Eid HO, Al-Hussona M, Idris KM, Abu-Zidan FM. Necrotizing fasciitis: a challenging diagnosis. Eur J Emerg Med Off J Eur Soc Emerg Med. 2007;14(1):50–2.
Voros D, Pissiotis C, Georgantas D, Katsaragakis S, Antoniou S, Papadimitriou J. Role of early and extensive surgery in the treatment of severe necrotizing soft tissue infection. Br J Surg. 1993;80(9):1190–1.
Lakshmanan MC, Hershey CO, Breslau D. Hospital admissions caused by iatrogenic disease. Arch Intern Med. 1986;146(10):1931–4.
Leibig N, Hirche C, Schmidt VJ, Bigdeli AK, Kneser U, Kremer T. Necrotizing fasciitis after central venous catheter placement. Surg Infect. 2014 Dec;15(6):850–2.
Bisno AL, Stevens DL. Streptococcal Infections of Skin and Soft Tissues. N Engl J Med. 1996;334(4):240–6.
Alsharari M, Pasquesoone L, Khater R, Guerreschi P, De Broucker V, Martinot-Duquennoy V. Necrotizing soft tissue infections following a scald burn of the lower limb: a case report. Ann Burns Fire Disasters. 2013;26(3):158–61.