The relevance of a fast and early diagnosis of necrotizing fasciitis in the Emergency Department: a case report

We report a case of necrotizing fasciitis in an 84-year-old man affected by diabetes mellitus. The patient was admitted in the Emergency Department of our hospital because of an acute and strong left leg pain that began almost 8 h before admission. The left leg had an increased size and a movement limitation, with a hard hematoma in the left thigh with subcutaneous crepitus. The lesion became worse and larger rapidly, with a wide extension from the back to the popliteal fossa. An antimicrobial therapy was immediately started with morphine for pain. A surgical debridement was performed, but the patient died for multi-organ failure. Necrotizing fasciitis is a rare and mortal disease, the early diagnosis is a challenge for the Emergency Department where patients are admitted and assessed primarily.