Kattan Abdullah E, AlQahtani Maha S, Sultan Faris A, Alshaalan Sultan F, Alkhars Hussam F, Alblawi Housen K, Al Mulhim Naif A
From the Division of Plastic Surgery, Department of Surgery, College of Medicine, King Saud University, King Saud University Medical City, Riyadh, Saudi Arabia.
College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Plast Reconstr Surg Glob Open. 2024 Dec 5;12(12):e6373. doi: 10.1097/GOX.0000000000006373. eCollection 2024 Dec.
This report describes a rare case of necrotizing fasciitis (NF) in a previously healthy 9-year-old girl, emphasizing the complexities and urgent needs associated with its diagnosis and treatment in children. NF, a severe soft-tissue infection characterized by rapid progression and often fatal outcomes, presents diagnostic challenges owing to nonspecific initial symptoms such as pain, erythema, and edema. This patient presented to the emergency department with fever, arm redness, and blisters after the initial discharge with antibiotics from another facility. Despite the lack of clear historical indicators for the cause, the clinical and laboratory findings, including a high Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score of 9, led to immediate surgical intervention. Treatment included multiple sessions of surgical debridement and broad-spectrum antibiotics, culminating in successful skin grafting. This case underscores the importance of high clinical suspicion and prompt surgical consultation to manage potential NF, mainly when the initial symptoms may be misleading. This report highlights the critical need for early recognition and aggressive treatment to improve the prognosis of pediatric cases of NF.
本报告描述了一例罕见的坏死性筋膜炎（NF）病例，患者为一名此前健康的9岁女孩，强调了儿童坏死性筋膜炎诊断和治疗的复杂性及迫切需求。坏死性筋膜炎是一种严重的软组织感染，其特点是进展迅速且往往导致致命后果，由于疼痛、红斑和水肿等非特异性初始症状，给诊断带来了挑战。该患者在另一家医疗机构使用抗生素初步出院后，因发热、手臂发红和出现水泡而到急诊科就诊。尽管缺乏明确的病因历史指标，但临床和实验室检查结果，包括坏死性筋膜炎实验室风险指标（LRINEC）评分为9分，促使立即进行手术干预。治疗包括多次手术清创和使用广谱抗生素，最终成功进行了皮肤移植。该病例强调了高度临床怀疑和及时进行外科会诊以处理潜在坏死性筋膜炎的重要性，尤其是当初始症状可能具有误导性时。本报告突出了早期识别和积极治疗对于改善儿童坏死性筋膜炎病例预后的迫切需求。
