Polymicrobial Necrotizing Fasciitis – A Fatal Outcome following Motor Vehicle Accident

Abstract

Necrotizing fasciitis is an uncommon skin infection characterized by rapidly progressing, extensive skin necrosisinvolving the soft tissues and superficial fascia. It begins with non-specific local cutaneous signs, posing adiagnostic difficulty for the clinicians, evolving into life-threatening systemic toxicity. Trauma is more oftenknown to be a causal infective etiology. The presence of underlying comorbidities has been observed in casesof necrotizing fasciitis. Various microorganisms, including a mix of anaerobes and aerobes, marine creatureslike vibrio, or even fungi, can cause necrotizing fasciitis. Thus, necrotizing fasciitis may be polymicrobial ormonomicrobial. We report a case of an 80-year-old pillion rider of a motorbike involved in a road traffic accident.The injury sustained resulted in an uncommon complication of polymicrobial necrotizing fasciitis, causing theindividual’s death. The microbial invasion of the skin is considered to release toxins, damaging tissues andcausing necrosis. Coagulase-negative staphylococci is a common human skin aerobic, gram-positive coccus. Ithas shown the propensity to cause bacteremia. Candida, a known invasive organism, can play a potential rolein fasciitis. This inter-microbial synergism may stimulate an aggressive systemic inflammation leading to septicshock