Keywords
How to Cite
Abstract
Necrotizing fasciitis is a soft tissue infection, with necrosis of the subcutaneous tissue, with a rapid and aggressive course. It affects all age groups, being rare in children and newborns, however, potentially fatal if not diagnosed and treated early. The present work aims to present a case report of a 12-day-old newborn hospitalized for an abscess in the right breast that progressed to necrotizing fasciitis. The patient started with an abscess in the right breast, which quickly progressed to tachycardia, groaning, skin mottling, cold extremities and slow capillary refill time, requiring admission to the Intensive care units . Debridement and initiation of antibiotic therapy were performed within the recommended time frame. During hospitalization, it was necessary to install a Tenckhoff catheter and use vasoactive drugs. On the day of discharge, the patient was in good general condition, with the wound healing. Attention to warning signs that contribute to early diagnosis, early treatment with broad-spectrum antibiotic therapy and surgical debridement within 24 hours, and adequate management of complications are essential for the patient's positive outcome.
References
Chen, L.L., Fasolka, B., & Treacy, C. (2020). Necrotizing fasciitis: A comprehensive review. Nursing, 50(9), 34-40. doi: 10.1097/01.NURSE.0000694752.85118.62.
Gupta, D. (2021). Bacterial skin and soft tissue infections in children. Pediatric Infectious Disease, 3(4), 146–55. doi: 10.5005/jp-journals-10081-1305.
Hankey, P. B., & Brown, J. (2022). Cervical necrotizing fasciitis and shock in the post-operative pediatric patient. Ear, nose & throat journal, 0, 1-4. doi: 10.1177/01455613221139404.
Hilton CM. (2023). Necrotizing fasciitis-a single center case series. Clinics in Surgery, 9:1–6.
Kang-Auger, G., Chassé, M., Quach, C., Ayoub, A., & Auger, N. (2021). Necrotizing Fasciitis: Association with Pregnancy-related Risk Factors Early in Life. The Yale Journal of Biology and Medicine, 94(4), 573. PMCID: PMC8686767.
Lodhia, J., Chussi, D., Ngowi, E., Laizer, L., Leanji, L., & Mchaile, D. (2021). Necrotizing fasciitis in a 5-week-old infant: an unusual presentation. Sage Open Medical Case Reports, 9, 1-4. doi: 10.1177/2050313X211037121.
Mercier, G., Parrado, R., Jenkins, D., & Streck, C. (2021). Use of a Dermal Matrix for an Open Chest Wound in a Newborn with Complicated Necrotizing Fasciitis. The American Surgeon, 89(6), 2767-2769. doi: 10.1177/00031348211054549.
Nazir, Z. (2005). Necrotizing fasciitis in neonates. Pediatric Surgery International, 21(8), 641-644. doi: 10.1007/s00383-005-1481-y.
Naranjo-Zúñiga, G., Yock-Corrales, A., Mora-Mesén, C., Campos-Villalobos, M., & Ulloa-Gutierrez, R. (2020). Epidemiology, clinical manifestations and microbiology of children with necrotizing fasciitis in a Costa Rican pediatric hospital. Revista chilena de infectología, 37(4), 446-449. doi: 10.4067/S0716-10182020000400446.
Okamoto, M., Tsuruno, Y., & Fukuzawa, H. (2023). Neonatal necrotizing fasciitis with gas gangrene due to peripherally inserted central catheter-related infection. Surgical case reports, 9 (1), 1-4. PMCID: PMC10267073.
Pantelić, M., Stojić, M.S., Petrović, D., Mladenović, S., Baturan, B., Tesić, I., & Golijan, B. (2023). Necrotizing fasciitis after total abdominal hysterectomy: A case report. Medicine (Baltimore), 102(31), 34451. doi: 10.1097/MD.0000000000034451.
Rudagi, B.M., & Londhe, P. (2021). Necrotizing fasciitis: a case report. What to do? When? And how? Scholars Journal of Medical Case Reports, 9(11), 1071–1075. doi: 10.36347/sjmcr.2021.v09i11.008.
Santos-Jasso, K., & Ridaura-Sanz, C. (2015). Fascitis necrosante secundaria a onfalitis en un recién nacido con hipoplasia del bazo. Acta pediátrica de México, 36(1), 36-42. Recuperado en 12 de noviembre de 2023, de http://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S0186-23912015000100007&lng=es&tlng=es.
Schröder, A., Gerin, A., Firth, G.B., Hoffmann, K.S., Grieve, A., & Oetzmann, C.V.S. (2018). A systematic review of necrotising fasciitis in children from its first description in 1930 to 2018. BMC Infectious Diseases, 19(1), 317. doi: 10.1186/s12879-019-3941-3.
Stevens, D.L., & Bryant, A. E. (2017). Necrotizing Soft-Tissue Infections. The New England Journal of Medicine, 377(23), 2253-2265. doi: 10.1056/NEJMra1600673.
Zundel, S., Lemaréchal, A., Kaiser, P., & Szavay, P. (2017). Diagnosis and treatment of pediatric necrotizing fasciitis: a systematic review of the literature. European Journal of Pediatric Surgery, 27(2), 127-137. doi: 10.1055/s-0036-1584531.
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2023 Kelson Rudy Ferrarini, Maria Luiza Bom-Ami Barros Mees, Luiza Fátima Krokoscz Martignoni, Maria Eduarda Pfau, Eduardo Augusto Pfau