Annals of Case Reports and Clinical Studies (ISSN: 2834-5673) | Volume 4, Issue 10 | Case Report | Open Access
Vedran Beara*
Vedran Beara1*, Tomislav Žuvela1, Vladimir Huić1, Zvonimir Križanac1, Frane Utroničić1, Veridijana Šunjić Roguljić1, Žana Rupić1 and Ivo Utrobičić2
1Department of Plastic, Reconstructive and Aesthetic Surgery and Burns, University Hospital Centre Split, Croatia
2Assistant Professor, Utrobičići 9, 21 310 Slime-Omiš, Croatia
*Correspondence to: Vedran Beara
Fulltext PDFBackground: Necrotizing Fasciitis (NF) is a rare but life-threatening soft tissue infection characterized by rapid fascial and subcutaneous tissue necrosis. Prompt diagnosis and aggressive surgical and medical intervention are crucial to reduce morbidity and mortality.
Case Presentation: We present a case series of three patients with distinct clinical presentations of NF, underscoring the diverse etiologies, risk factors, and management challenges. The first case involved a paraplegic male with extensive sacral and gluteal NF, illustrating the heightened vulnerability in patients with impaired mobility and chronic pressure injuries. The second patient, a previously healthy middle-aged man, developed NF following a marine-related injury, emphasizing the infectious potential of aquatic environments. The third case featured an immunocompromised female with a history of breast cancer, whose atypical presentation delayed diagnosis.
Management and Outcomes: All patients received empirical broad-spectrum antibiotics and underwent prompt, radical surgical debridement, which remains the cornerstone of NF treatment. Reconstructive efforts included the use of cadaveric heterografts and split-thickness skin grafts. While two patients achieved satisfactory wound closure, one required hip disarticulation due to failed reconstruction, highlighting the complexity of managing extensive soft tissue loss in patients with limited physiological reserve. All patients survived, despite high predicted mortality based on known risk factors, including diabetes, immunosuppression, chronic liver disease, and delayed recognition.
Conclusion: This series reinforces the importance of early recognition, broad-spectrum antimicrobial therapy, and aggressive surgical management in improving survival in NF. Although all patients survived, the cases reflect the significant morbidity, prolonged hospitalization, and reconstructive challenges associated with NF. Awareness of atypical presentations and risk factors is essential for timely intervention and optimizing outcomes.
Necrotizing fasciitis; Soft tissue infection; Surgical infection management; Surgical debridement; Tissue reconstruction
Vedran Beara, Tomislav Žuvela, Vladimir Huić, Zvonimir Križanac, Frane Utroničić, Veridijana Šunjić Roguljić, et al. Necrotizing Fasciitis: A Three Case Series Highlighting Diagnostic Challenges and Treatment Approaches. Ann Case Rep Clin Stud. 2025;4(10):1-16.