[Multifocal necrotizing fasciitis: presentation of a case].

INTRODUCTION

Multifocal necrotizing fasciitis is a condition in which there is more than one non-contiguous body area affected, and it is usually the result of the dissemination of septic emboli.

CLINICAL CASE: We present a 67 year-old patient, on oral corticosteroid treatment, who was admitted with a septic shock. The previous week he had been operated on due to the perforation of a colon diverticulum. He had signs that suggested necrotizing fasciitis on all four limbs which progressed quickly. Emergency fasciotomies on all limbs were performed, and empirical antibiotic treatment was started.

RESULTS

After the surgery the patient improved, and seven days after the debridement, primary closure of the wounds was performed. Tissue cultures were negative.

DISCUSSION: Being a rare entity, there is no consensus regarding the management of multifocal necrotizing fasciitis. However, early and aggressive debridement (including fasciotomies and even amputation) and broad-spectrum antibiotics are essential for its treatment.