Case Report
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 6, 2019; 7(21): 3595-3602
Published online Nov 6, 2019. doi: 10.12998/wjcc.v7.i21.3595
Multidisciplinary treatment of a patient with necrotizing fasciitis caused by Staphylococcus aureus: A case report
Li-Qian Xu, Xin-Xiu Zhao, Pei-Xia Wang, Ji Yang, Yun-Mei Yang
Li-Qian Xu, Xin-Xiu Zhao, Pei-Xia Wang, Ji Yang, Yun-Mei Yang, Department of Geriatrics, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
Author contributions: Xu LQ collected the case data; Xu LQ and Zhao XX wrote the manuscript; Wang PX and Yang J prepared the photos and proofread the imaging materials; Yang YM proofread and revised the manuscript; all of the authors approved the final version to be published.
Supported by National Key Clinical Specialities in the Twelfth Five-Year Plan (Geriatrics Department); “ Demonstration Base of Clinical Nutrition for the Elderly” initiated and sponsored by the China Health Promotion Foundation.
Informed consent statement: Informed consent was obtained from the patient.
Conflict-of-interest statement: The authors declare that there is no conflict of interest related to this report.
CARE Checklist (2016) statement: The manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Yun-Mei Yang, PhD, Chief Physician, Department of Geriatrics, The First Affiliated Hospital, College of Medicine, Zhejiang University, No. 79, Qingchun Road, Hangzhou 310003, Zhejiang Province, China. 1194070@zju.edu.cn
Telephone: +86-571-87236808 Fax: +86-571-87236808
Received: April 9, 2019
Peer-review started: April 12, 2019
First decision: September 9, 2019
Revised: September 30, 2019
Accepted: October 15, 2019
Article in press: October 15, 2019
Published online: November 6, 2019
Processing time: 213 Days and 13.1 Hours
Abstract
BACKGROUND

Necrotizing fasciitis is a severe bacterial skin infection that spreads quickly and is characterized by extensive necrosis of the deep and superficial fascia resulting in the devascularization and necrosis of associated tissues. Because of high morbidity and mortality, accurate diagnosis and early treatment with adequate antibiotics and surgical intervention are vital. And timely identification and treatment of complications are necessary to improve survival of patient.

CASE SUMMARY

We report a case of necrotizing fasciitis caused by Staphylococcus aureus in a patient using high doses of glucocorticoid and suffering from secondary diabetes mellitus. He was admitted to our hospital due to redness and oedema of the lower limbs. After admission, necrotizing fasciitis caused by Staphylococcus aureus was considered, and he was discharged after B-ultrasound drainage and multiple surgical operations. In the process of treatment, multiple organ functions were damaged, but with the help of multi-disciplinary treatment, the patient got better finally.

CONCLUSION

The key to successful management of necrotizing fasciitis is an early and accurate diagnosis. The method of using vacuum sealing drainage in postoperative patients can keep the wound dry and clean, reduce infection rate, and promote wound healing. Interdisciplinary collaboration is a vital prerequisite for successful treatment.

Keywords: Necrotizing fasciitis; Surgical debridement; Vacuum sealing drainage; Multi-disciplinary treatment; Case report

Core tip: Diagnosis of necrotizing fasciitis is difficult due to absence of typical signs. Some imaging techniques involving computed tomography, magnetic resonance imaging, and ultrasound could provide valuable morphological features for diagnosis of necrotizing fasciitis. Our case highlights the importance of a combination of antibiotics, multiple surgical debridements, and multi-disciplinary treatment for the successful management of the patient with necrotizing fasciitis caused by Staphylococcus aureus.