Abstract
Necrotizing fasciitis is a severe and progressive infection of deep soft tissues which results in destruction of the fascia and overlying subcutaneous fat. We report a case of a 45-year-old diabetic gentleman who initially presented with left shoulder pain, which was treated symptomatically. Upon representation, he had fever and the pain extended to his left upper back. There was a warm, firm and mildly tender purplish swelling on his mid to the left upper back. Blood tests revealed significantly elevated white cell counts and C-reactive protein. A CT thorax showed extensive soft tissue gas within the deep and superficial fascial layers of his left upper back. Necrotizing fasciitis was confirmed intraoperatively. The diagnosis of this condition is often difficult as early symptoms can be mild and nonspecific. A high Laboratory Risk Indicator for NECrotizing fasciitis (LRINEC) score may be helpful to rule in this diagnosis and guide further management.
Highlights
Blood tests revealed significantly elevated c white cell counts and C-reactive protein
We report a case of o a 45-year-old diabetic gentleman who initially presented with left shoulder pain, e which was treated symptomatically
Necrotizing fasciitis should always be suspected when the presentation is disproportionate to the clinical findings, for example when there is severe pain with
Summary
Blood tests revealed significantly elevated c white cell counts and C-reactive protein. Necrotizing fasciitis is a severe and proly gressive infection of deep soft tissues which results in destruction of the fascia and overn lying subcutaneous fat. We report a case of o a 45-year-old diabetic gentleman who initially presented with left shoulder pain, e which was treated symptomatically.
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