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Fasciitis necrotisans - duplicitas casuum

Publication at Faculty of Medicine in Hradec Králové |
2018

Abstract

Necrotizing fasciitis is a dangerous bacterial infectious disease that is not commonplace in Czech society. On the other hand, neither is it so rare that the majority of surgeons should not come across in occasionally.

In the early stages, pathological changes in fascia, subcutaneous tissue and even skin may run an incospicuous course. However, this can rapidly deteriorate into schock and sepsis which may lead to multi-organ failure and an imminent life-threatening condition.

The fatality rate of necrotizing fasciitis among high-risk groups (e.g. diabetics, patients who are immuno-compromised, obese and/or elderly, malnourished, or with a history of drug use), is particularly steep, reaching as high as 73%. Treatment for this condition consists of early, radical sugical intervention in conjunction with targeted antibiotherapy.

Comple resuscitative and intensive care, including rehabilitation, are standard components of post-surgical management. Use of hyperbaric oxygen therapy, if such an opportunity exists, is also recommended.

Interdisciplinary collaboration is a vital prerequisite for successful treatment. This article describes two case-studies of necrotizing fasciitis that occurred in men of similar age during a three-year period.

Both patients presented with very similar and complicated disease courses, and both were successfully treated by the same interdisciplinary team comprised of clinicians from various specialized departments.