Locked Posterior Shoulder Dislocation with a Large Bone Defect in an Active Patient Treated with Autograft.

INTRODUCTION

Necrotizing fasciitis (NF) is a life-threatening soft-tissue infection. While the fulminate form is well documented, the subacute NF is rarely reported. Failure to consider NF as a diagnosis during this indolent presentation can be detrimental to patients because the surgical aggressive debridement remains the key of the treatment.

CASE REPORT: We report a case of a 54-year-old man who developed a subacute NF. After an initial diagnosis of cellulitis, the patient failed to show improvement with antibiotic treatment; he was referred to our institution in view to benefit of a surgical management. The patient developed progressive systemic toxic symptoms and an emergency debridement was made 10 h after his admission. Our patient achieves to show improvement with antibiotic treatment, vacuum-assisted closure therapy, hyperbaric oxygen therapy, and reconstructive surgery. Complete recovery was observed after 2 months.

CONCLUSION

NF is a surgical emergency. Early diagnosis is essential, it is often ambiguous and commonly misdiagnosed including the subacute form. There needs to be a high suspicion for NF even in patients presenting with cellulitis without systemic symptoms.