A rare rapidly-spreading necrotizing infection of the skin and soft tissues, Meleney\'s synergistic gangrene is characterized by a synergistic infection with both staphylococci and microaerophilic streptococci. This report presents a case of Meleney\'s synergistic gangrene in a young female patient with no comorbidities and no surgical history who was initially misdiagnosed as a case of perineal abscess and later after the culture report and course of the spread of infection, it was diagnosed as a case of Meleney\'s synergistic gangrene. The patient underwent serial debridements with a combination of broad-spectrum antibiotic cover followed by secondary closure of the wound and the patient was followed up after three months post-discharge and showed full recovery with no recurrence of infection.

Background There is great variation in the etiology, predisposing organisms, incidence, clinical characteristics, severity, and consequences of skin and/or subcutaneous tissue infections. Extensive necrosis of the subcutaneous tissues and fascia is a characteristic of necrotizing soft tissue infections, which are frequently deadly. To change the course of treatment, this study highlights the need to find a tool that can quickly and accurately identify patients with necrotizing fasciitis (NF) and assist in making an early treatment decision. Methodology A prospective evaluation of 30 individuals with soft tissue infections was conducted using the laboratory risk indicator for necrotizing fasciitis (LRINEC). The patients were classified as low, intermediate, and high risk for the start of NF based on their LRINEC score. To assess the importance of the LRINEC score in forecasting the start of NF and its clinical consequences, patients in each group underwent appropriate management and statistical analysis. Results This study included 28 males (93.3%) and two females (6.7%). The associated p-value, recorded as 0.039, signifies statistical significance in the observed area under the receiver operating characteristic (ROC) curve. The p-value in risk categorization was found to be 0.296, which suggests that LRINEC helps in risk categorization with 100% sensitivity when used as a screening tool. Conclusion The early detection of necrotizing soft tissue infections, such as NF, is vital. The LRINEC score, based on routine lab tests, accurately distinguishes these infections. With high sensitivity and significant p-values, it helps stratify patients, guiding timely interventions and saving lives.

Necrotizing fasciitis is an aggressive bacterial infection that causes necrosis of the fascia and subcutaneous tissues with rapid progression and high mortality. Early stages often lead to misdiagnosis, resulting in improper treatment and severe implications. This case study presents a patient with diabetes mellitus combined with hepatitis B who rapidly developed necrotizing fasciitis of the left forearm and left breast after trauma and controlled the infection with early surgical treatment. It is worth noting that early surgical exploration is the gold standard for the diagnosis of necrotizing fasciitis and is the most effective means of reducing mortality and amputation rates in necrotizing fasciitis.

Necrotizing fasciitis (NF) is a rare, dangerous, potentially fatal infectious disease of soft tissue. The treatment consists of antibiotic therapy, surgical debridement and subsequent reconstruction. Hyperbaric oxygen (HBO) therapy has been applied in NF patients recently, so our aim was to gather the findings and outcomes for HBO therapy. A PubMed and Google Scholar literature search was conducted regarding the effect of HBO therapy in patients with NF following key words: \'necrotizing fasciitis\' AND \'maxillofacial region\' OR \'head and neck\' AND \'hyperbaric oxygen\' OR \'HBO\'. A total of 3333 studies have been identified, of which only 16 articles met the inclusion criteria of this review. A conclusion was made, that aggressive combinations of antibiotics and surgical debridement followed by incorporation of HBO therapy, as an adjuvant treatment, in patients with NF and in company by immunoglobulin therapy are showing promising results. In addition, multi-centric studies should be in consideration for further research.

Although squirrel bites are uncommon and generally benign, they have been implicated in the transmission of certain diseases in humans, some of which can be life-threatening. This report discusses the case of a 27-year-old hunter who developed a necrotizing soft tissue infection with vesiculo-bullous skin lesions after a ground squirrel bite.

Necrotizing fasciitis, a rare, potentially life-threatening infection, often necessitates urgent medical intervention and surgical excision of the affected tissue. We present a 55-year-old male patient with a progressively enlarging lump in the left breast that was diagnosed as a breast carcinoma. Post-modified radical mastectomy, histopathological examination revealed Grade II invasive ductal carcinoma with neuroendocrine features. Due to financial constraints, the patient missed post-operative follow-ups and did not complete the prescribed radiotherapy sessions. Three months later, the patient returned with fever, swelling alongside sharp pain in the left arm and oozing blood. A clinical diagnosis of necrotizing fasciitis was made, leading to urgent surgical debridement. While the wound progressively healed, a contracture developed restricting elbow movement. An Orthopedic Review and Bone scintigraphy revealed metastasis of breast carcinoma to the sternum. This case report highlights the multi-disciplinary management required in such financially constrained rare cases in low- and middle-income countries.

Necrotizing fasciitis (NF) is a life-threatening soft-tissue infection that requires early recognition and surgical debridement to ensure the best outcome for patients. The Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score and the SIARI (Site other than lower limb, Immunosuppression, Age <60 years, Renal Impairment and Inflammatory markers) score are clinical predictor tools that can aid in the timely diagnosis of NF. This case report discusses a male patient who presented with a rash on his arm that was initially thought to be cellulitis. It examines how the application of scoring systems can be beneficial for earlier identification or when the diagnosis is uncertain.

Periorbital necrotizing fasciitis (NF) is a devastating bacterial infection associated with irreversible inflammatory destruction of soft tissues. Outcomes include disfigurement, vision loss, septic shock, and death within hours to days. We describe two cases of periorbital NF that presented to our unit within a three-month period. We aim to highlight the key clinical features of periorbital NF, demonstrate the rapid progression of the disease, and the need for prompt identification and decisive intervention. Both patients presented with fever and left-sided periorbital swelling and showed rapid progression of swelling and gangrenous changes to the periorbital skin with worsening proptosis. They were treated with broad-spectrum intravenous antibiotics and underwent emergency surgical debridement of necrotic tissue followed by reconstruction. We propose a formal protocol that we recommend to aid the diagnosis and management of periorbital NF in an acute setting.

Necrotizing fasciitis (NF) is a rapidly progressive bacterial infection with high mortality. Invasive group A Streptococcus (GAS) infection is the leading cause of NF. Our understanding regarding clinicopathological features and pathogenesis of invasive GAS infection is expanding as the incidence of NF in healthy individuals increases. However, clinicopathological features of NF in the presence of autoimmune diseases have been poorly defined. We experienced NF in a patient treated with infliximab and prednisolone for ulcerative colitis and rheumatoid arthritis. Herein, we present time kinetics findings of clinical symptoms and laboratory data of GAS-associated NF in the presence of immunosuppressant-treated immune disorders.

BACKGROUND: Necrotizing fasciitis (NF) is a critical disease with high morbidity and mortality rates that poses significant challenges in diagnosis and treatment. Prognostic factors for the clinical course of NF remain unclear and are currently under research. This study aims to identify such factors in a large cohort of patients which represents a major comprehensive investigation of prognostic factors for NF.
METHODS: Retrospective analysis was conducted on necrotizing fasciitis cases from 2003 to 2023 at two German hospitals. Data included demographics, comorbidities, laboratory findings, infection site, causative microorganisms and outcomes. Statistical analysis involved t-tests, chi-square tests, and ROC analysis.
RESULTS: A total of 209 patients were included, with a mortality rate of 18%. Patients were categorized into survivors (n = 171) and non-survivors (n = 38). Non-survivors were significantly older (68.9 ± 13.9 years vs. 55.9 ± 14.3 years; p < 0.01) and exhibited a higher prevalence of peripheral vascular diseases, cancer, and heart, liver, or renal insufficiency. Laboratory findings and scoring results also varied significantly between the two groups. The ROC curve analysis identified age as a predictor of mortality, with an optimal cut-off value of 68.5 years (sensitivity: 60.5%, specificity: 81.9%). Higher age was associated with increased mortality risk.
CONCLUSIONS: The patient\'s age stands out as the primary predictive element for mortality in necrotizing fasciitis. Additionally, we advocate for employing the Laboratory and Anamnestic Risk Indicator for Necrotizing Fasciitis (LARINF-score), which holds substantial prognostic significance and is straightforward to calculate. Considering our findings, crafting a clinical algorithm or scoring mechanism to forecast mortality in NF would be a promising target for future research.