Emergency Surgical Management of Rapidly Progressive Necrotizing Fasciitis in an Infant: A Case Report

Abstract

Aims: To present an infant with necrotizing fasciitis following NSAID administration for cutaneous erythema. We describe the therapeutic management, clinical course, and discuss the potential association between NSAID use and the development of necrotizing fasciitis. Case Presentation: This case involves an 18-month-old infant with no medical or surgical history who had been treated with non-steroidal anti-inflammatory drugs (NSAIDs) for a truncal erythema. One month after treatment, the child developed fulminant necrotizing fasciitis of the left upper limb, extending to the left flank, accompanied by severe septicemia Discussion: Necrotizing fasciitis is a rare and severe infectious disease. In pediatrics and neonatology, several predisposing factors contribute to the development of necrotizing fasciitis. The evolution of necrotizing fasciitis is extremely rapid, with the appearance of blisters, cutaneous necrosis, and a marked deterioration in the patient's general condition. It constitutes a surgical emergency. The role of non-steroidal anti-inflammatory drugs (NSAIDs) as a risk factor for necrotizing fasciitis has been a subject of controversy. Conclusion: This case clearly illustrates that the spread of the infection beyond the upper limb quickly becomes life-threatening and highlights the importance of radical excisional surgery to eradicate the infection. NSAIDs should be avoided in the management of cutaneous erythema, particularly in children, to mitigate the risk of developing necrotizing fasciitis - a potentially life-threatening condition.