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Journal of Long-Term Effects of Medical Implants
SJR: 0.332 SNIP: 0.491 CiteScore™: 0.89

ISSN Druckformat: 1050-6934
ISSN Online: 1940-4379

Journal of Long-Term Effects of Medical Implants

DOI: 10.1615/JLongTermEffMedImplants.2019030061
pages 309-317

SEPSIS SECONDARY TO DELAYED PRESENTATION OF NECROTISING FASCIITIS OF THE THIGH—PRESENTATION OF TWO CASES WITH A POOR OUTCOME

Alexandros P. Apostolopoulos
Trauma and Orthopaedic Department, Prince Charles Hospital, London, UK
Anastasios Tsiotsias
Trauma and Orthopaedic Department, Red Cross Hospital, Athens, Greece
George Zouboulis
Trauma and Orthopaedic Department, Red Cross Hospital, Athens, Greece
Efthymios Karadimas
Trauma and Orthopaedic Department, Red Cross Hospital, Athens, Greece
Stylianos Pernientakis
Trauma and Orthopaedic Department, Red Cross Hospital, Athens, Greece
Theodore Balfousias
Trauma and Orthopaedic Department, Red Cross Hospital, Athens, Greece
Athanasios Papanikolaou
Trauma and Orthopaedic Department, Red Cross Hospital, Athens, Greece

ABSTRAKT

Necrotizing fasciitis is an extremely virulent form of infectious fasciitis. It affects skin, subcutaneous fat, and superficial and deep muscular fascia by rapidly progressive necrosis. We present two cases, a 54-year-old female patient and a 46-year-old male patient, who presented to the emergency department of our hospital 30 days and 14 days after the onset of symptoms, respectively, with progressively deteriorating pain and swelling of the thigh, accompanied by fever, nausea, sweating, shortness of breath, and sepsis. Clinical, laboratory, and imaging findings suggested thigh fasciitis, which was secondary to osteomyelitis of the femoral head in one case. Despite the urgent surgical exploration and debridement, multiple courses of various schemes of intravenous antibiotics administered, the numerous surgical debridements and interventions performed, and the prolonged hospitalization in the intensive care unit, both patients died due to multiple-organ failure and disseminated intravascular coagulation. Necrotizing fasciitis is of surgical urgency with a high mortality rate, and early surgical intervention is of vital importance. In both of these cases, delayed presentation to the hospital was of great significance to the final outcome.


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