Description
A 57-year-old man presented to the emergency department with fever, chills and a wound on his left foot since 2 weeks. He had no previous medical history. Despite receiving flucloxacillin, the wound was neglected and became necrotic with skin discoloration and a purulent, foul-smelling discharge. The leg developed functional impairment with severe claudication pain. All digits were pale, cold and numb (figure 1A, B). Biochemistry showed high infection parameters and hyperlactaemia as a sign of hypoperfusion. Hyperglycaemia revealed de novo diabetes. X-rays of the left lower extremity showed subcutaneous air (figure 2A–C).
Figure 1
(A,B) The extension of necrotising fasciitis of the left lower extremity.
Figure 2
X-rays of the foot (A) and knee (B and C) showing subcutaneous air (arrows), which is typical of necrotising fasciitis.
Patient underwent immediate left transfemoral amputation. Postoperatively he was...
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