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Necrotising fasciitis of the thoracic wall: a rare case with favourable outcome
  1. Rodrigo Athayde Nemésio1,2,
  2. Ana Ruivo3,4,
  3. Alexandre Monteiro3 and
  4. José Guilherme Tralhão3,4
  1. 1General Surgery Department, Centro Hospitalar e Universitário de Coimbra EPE, Coimbra, Coimbra, Portugal
  2. 2Clinica Universitária de Cirurgia, University of Coimbra Faculty of Medicine, Coimbra, Coimbra, Portugal
  3. 3General Surgery Department, Coimbra University Hospital Centre, Coimbra, Portugal
  4. 4Clinica Universitária de Cirurgia, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
  1. Correspondence to Dr Rodrigo Athayde Nemésio; rnemesio{at}gmail.com

Abstract

Necrotising fasciitis (NF) is a severe infection of the subcutaneous tissue and fascia that can rapidly lead to sepsis and shock with high mortality rates. Its initial signs are often non-specific making it difficult for an early diagnosis to be reached. Nevertheless it is of the utmost importance to begin proper treatment including wide surgical debridement as soon as possible in order to avoid death. We present the case of a patient with NF of the thoracic wall which is a rare location for this disease but often associated with worse prognosis. Even though he progressed to septic shock within less than 24 hours of its presentation, due to early surgical management, aggressive resuscitation and intensive care support, he reached a favourable outcome. After three surgical revisions and 2 weeks in an intensive care unit, the patient was discharged from hospital 35 days after admission.

  • emergency medicine
  • general surgery

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Footnotes

  • Contributors RAN performed the surgical procedure, collected the data, performed the literature search, wrote the manuscript and reviewed the final version. AR contributed to the surgical procedure and revision of the manuscript. AM performed the surgical procedure and contributed to the manuscript’s revision. JGT critically reviewed the final version.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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