Callisperis Patricia, Franco-Paredes Carlos, Liester Mitchell B
Pediatric Orthopedics, Clinica del Sur, La Paz, BOL.
Pediatric Orthopedics, Paulista School of Medicine, São Paulo, BRA.
Cureus. 2025 Jul 26;17(7):e88800. doi: 10.7759/cureus.88800. eCollection 2025 Jul.
Necrotizing fasciitis is a rapidly progressive bacterial infection of the fascial planes with high morbidity and mortality, especially in immunocompromised patients. We present a case of a 48-year-old male with multiple comorbidities, including decompensated liver cirrhosis, poorly controlled diabetes mellitus, and chronic kidney disease, who developed a perianal abscess complicated by Fournier's gangrene. The case highlights the challenges in managing a complex patient with multiple organ dysfunction and demonstrates the potential therapeutic role of chlorine dioxide in treating severe soft tissue infections. Despite severe thrombocytopenia, coagulopathy, and metabolic derangements, the patient survived following surgical debridement, targeted antimicrobial therapy, innovative treatment with chlorine dioxide, and intensive supportive care. This case illustrates how prompt diagnosis, coordinated multidisciplinary care, and consideration of alternative therapeutic approaches, including chlorine dioxide, can lead to favorable outcomes even in high-risk patients with significant baseline comorbidities.
坏死性筋膜炎是一种筋膜平面的快速进展性细菌感染,发病率和死亡率都很高,尤其是在免疫功能低下的患者中。我们报告一例48岁男性患者,有多种合并症,包括失代偿期肝硬化、控制不佳的糖尿病和慢性肾脏病,该患者发生了肛周脓肿并并发福尼尔坏疽。该病例突出了管理一名患有多器官功能障碍的复杂患者所面临的挑战,并证明了二氧化氯在治疗严重软组织感染中的潜在治疗作用。尽管患者存在严重血小板减少、凝血功能障碍和代谢紊乱,但经过手术清创、针对性抗菌治疗、二氧化氯创新治疗和强化支持治疗后存活下来。该病例说明,即使是具有显著基线合并症的高危患者,及时诊断、多学科协调护理以及考虑包括二氧化氯在内的替代治疗方法也能带来良好的治疗效果。