BACKGROUND: Multifocal necrotizing fasciitis is a condition in which there is more than one non-contiguous body area affected, and it is usually the result of the dissemination of septic emboli.
METHODS: We present a 67 year-old patient, on oral corticosteroid treatment, who was admitted with a septic shock. The previous week he had been operated on due to the perforation of a colon diverticulum. He had signs that suggested necrotizing fasciitis on all four limbs which progressed quickly. Emergency fasciotomies on all limbs were performed, and empirical antibiotic treatment was started.
RESULTS: After the surgery the patient improved, and seven days after the debridement, primary closure of the wounds was performed. Tissue cultures were negative.
CONCLUSIONS: Being a rare entity, there is no consensus regarding the management of multifocal necrotizing fasciitis. However, early and aggressive debridement (including fasciotomies and even amputation) and broad-spectrum antibiotics are essential for its treatment.