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NECROTISING FASCITIS IN A NEONATE
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Neelu Desai, Sujata Sharma
Dept of Pediatrics, TN Medical College, BYL Nair Hospital, Mumbai 400008
Address for correspondance:Dr Neelu Desai, Vishnuprasad, 2nd floor, 69, Ranade road, Dadar [w], Mumbai 400028
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Case
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A full term 16 days old female infant weighing 2 kgs was admitted for fever, lethargy and refusal to feed. Physical examination revealed erythematous, tender area over the back with gangrenous changes and generalized skin exfoliation. Immediate extensive surgical debridement of the necrotic tissue and fascia was done. Intravenous antibiotics, fluid resuscitation and analgesia were commenced. The wound culture grew staphylococcus aureus. Skin biopsy showed septal panniculitis with damaged connective tissue and dystrophic fibres corroborating with the diagnosis of necrotizing fascitis. The patient succumbed to septicemia on day 13 of hospital stay.
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Figure 1: Necrotizing fascitis with exposure of underlying bone
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Discussion
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Necrotizing fascitis is rare in newborn [66 cases reported] with a fulminant course and high mortality [59%]. It is a bacterial infection of skin, subcutaneous tissue and fascia characterized by rapid spread, marked tissue edema and systemic toxicity. Wound cultures are polymicrobial. Hyperbaric oxygen and skin grafting have been tried but could not be done in our patient with our limited resources.
Last updated: 1-07-2006
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How to cite this url |
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Desai N, Sharma S. NECROTISING FASCITIS IN A NEONATE. Pediatric Oncall [serial online] 2006 [cited 2006 July 1];3. Available from:
http://www.pediatriconcall.com/fordoctor/viewersChoice/
necrotising_fascitis.asp |
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