RT Book, Section
A1 Usatine, Richard P.
A1 Smith, Mindy A.
A1 Chumley, Heidi S.
A1 Mayeaux, E.J.
SR Print(0)
ID 57677602
T1 Chapter 122. Necrotizing Fasciitis
T2 The Color Atlas of Family Medicine, 2e
YR 2013
FD 2013
PB The McGraw-Hill Companies
PP New York, NY
SN 978-0-07-176964-8
LK accessmedicine.mhmedical.com/content.aspx?aid=57677602
RD 2024/04/25
AB A  54-year-old  woman  with  diabetes  was  brought  to  the  emergency  department  with  right  leg  swelling,  fever,  and  altered  mental  status.1  The  patient  noted  a  pimple  in  her  groin  5  days  earlier  and  over  the  past  few  days  had  increasing  leg  pain.  Her  right  leg  was  tender,  red,  hot,  and  swollen  (Figure  122-1).  Large  bullae  were  present.  Her  temperature  was  38.9°C  (102°F)  and  her  blood  sugar  was  573.  The  skin  had  a  “woody”  feel  and  a  radiograph  of  her  leg  showed  gas  in  the  muscles  and  soft  tissues  (Figure  122-2).  She  was  taken  to  the  operating  room  for  debridement  of  her  necrotizing  fasciitis.  Broad-spectrum  antibiotics  were  also  started  but  the  infection  continued  to  advance  quickly.  The  patient  died  the  following  day;  her  wound  culture  later  grew  Escherichia  coli,  Proteus  vulgaris,  Corynebacterium,  Enterococcus,  Staphylococcus  sp.,  and  Peptostreptococcus.1