Necrotizing fasciitis in children due to minor lesions

Abstract

Introduction: Necrotizing fasciitis is a soft tissue infection that can rapidly progress and end lethally if not treated early and radically. With an extremely low prevalence (0.02% of all pediatric in hospital cases), most physicians will probably only see very few cases during their career. Unlike adult patients, the majority of children affected by this disease are healthy individuals. There is no chronic disease and necrotizing fasciitis often arises from minor lesions. Case presentation: We present two cases treated in our clinic within the past year. Our first case of necrotizing fasciitis was a 5 year old Caucasian male patient with a varicella lesion on the back. The second case, a 4 year old Caucasian male patient, presented after an insect bite at the lower limb. Both cases were triggered by a superinfection after scratching. We describe the clinical findings, difficulties in diagnosis, surgical therapy and outcome. Conclusion: Rapid surgical treatment is necessary to reduce morbidity and mortality in cases of necrotizing fasciitis. Due to the rarity of the disease it is often misdiagnosed by physicians. We emphasize the importance of staying alert and to keep necrotizing fasciitis in mind.

Keywords

• Necrotizing fasciitis
• Soft tissue infection
• Pediatrics
• Varicella