Extensive Cervicofacial and Truncal Necrotizing Fasciitis in the Puerperium: Successful Management with Surgical Debridement and Skin Grafting
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Abstract
Background: Necrotizing fasciitis (NF) is an uncommon, acute, and fast spreading soft tissue infection with a high morbidity and mortality unless early infections are detected and treated. The puerperium cervicofacial and truncal invasion is extremely rare.
Case presentation: We describe a 23-year-old rural Nigerian woman from Jigawa State who presented with widespread cervicofacial and truncal necrotizing fasciitis that developed three weeks after childbirth and was initially treated traditionally. At admission, she reported having a high-grade fever, sepsis, and multiple discharging sinuses on her neck and upper trunk. Wound and vaginal cultures showed Staphylococcus aureus and Streptococcus species, respectively. Emergency resuscitation, broad-spectrum antibiotics, and numerous surgical debridement’s were performed, followed by honey dressings and subsequent skin grafting, leading to complete recovery.
Conclusion: This case highlights the risks of late hospital presentation and application of traditional therapies and the relevance of early diagnosis, multidisciplinary management and reconstructive intervention to deliver positive outcomes in postpartum necrotizing fasciitis in contexts with limited resources.
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