Abstract
Necrotizing fasciitis is a rare and lethal bacterial infection of the subcutaneous tissue and fascia in pediatrics, particularly when Pseudomonas Aeruginosa is involved. The similarity between cellulitis and Necrotizing fasciitis can lead to misdiagnosis. A 5-month-old male is introduced, presenting with fever and ecchymoses on his left thigh, which was treated as cellulitis. However, the diagnosis was changed to necrotizing fasciitis due to rapid progression in infection and pseudomonas growth in cultures. The antibiotics were leveled up, and the surgeon debrided and grafted the skin. Finally, the patient was discharged in good condition. In the early stages of soft tissue infections, it is not possible to distinguish Necrotizing fasciitis from cellulitis, so empirical antibiotics should be started to cover poly-microbial infections, and the patient should be observed closely. When the infection does not respond to the antibiotics appropriately over 24 hours, the surgeon.
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