Rare Presentation of Neonatal Necrotizing Fasciitis: Case Series and Review of Literature

Aims and background: Necrotizing fasciitis is a rare, severe, fulminating disorder infecting all the layers of skin and extending to the fascial planes and muscular layer. It is an unusual presentation of septicemia in neonates and is, to a larger extent, a disease of immunocompromised adults. Thus,...

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Main Authors: Kruti N Shah, Shwetal Bhatt, Dipal Zanzrukriya, Salesh K Soni
Format: Article
Language:English
Published: Jaypee Brothers Medical Publisher 2024-07-01
Series:Pediatric Infectious Disease
Subjects:
Online Access:https://www.pidjournal.com/doi/PID/pdf/10.5005/jp-journals-10081-1436
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author Kruti N Shah
Shwetal Bhatt
Dipal Zanzrukriya
Salesh K Soni
author_facet Kruti N Shah
Shwetal Bhatt
Dipal Zanzrukriya
Salesh K Soni
author_sort Kruti N Shah
collection DOAJ
description Aims and background: Necrotizing fasciitis is a rare, severe, fulminating disorder infecting all the layers of skin and extending to the fascial planes and muscular layer. It is an unusual presentation of septicemia in neonates and is, to a larger extent, a disease of immunocompromised adults. Thus, there is a lack of reported neonatal cases. It could be misdiagnosed as cellulitis or myonecrosis due to its nonspecific presentations. It becomes essential to diagnose in a timely manner and culminate in a multidisciplinary approach with antimicrobial treatments and surgical aid to prevent its fulminating course. Thus, we aim to report three cases of necrotizing fasciitis presented in neonatal age, presented to us within a short span of 6 months, and sensitize its neonatal presentation with distinct clinical features. Case description: We report three cases of necrotizing fasciitis presented in neonatal age with varied clinical features, presenting as deep ulcers with fasciitis and scalp abscesses with no history of perinatal infections. The wound culture may not necessarily be septic. However, a multidisciplinary approach involving broad-spectrum intravenous antimicrobial therapy with advanced plastic surgical methodologies can help attenuate its fulminant course. Timely diagnosis and prompt intervention may aid in complete recovery, as in our cases, and thus prevent fatality. Conclusion: Neonatal necrotizing fasciitis is a progressive, fulminating infection of the skin, subcutaneous tissues, and fascial planes and may extend to muscular levels. We aim to sensitize the presence of necrotizing fasciitis as an unusual presentation of neonatal septicemia, encourage prompt diagnosis, and adopt a multidisciplinary approach. Clinical significance: Neonatal necrotizing fasciitis, though infrequent, carries a fatal, fulminating course. It is primarily a polymicrobial infection involving deep skin layers with extension to muscular planes. The diagnosis is usually clinical. Timely diagnosis with prompt antimicrobial treatment and surgical intervention helps reduce grave complications and mortality rates.
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spelling doaj-art-ae5866ed84ea4b8bbc6911b530542c092025-02-07T11:21:56ZengJaypee Brothers Medical PublisherPediatric Infectious Disease2582-49882024-07-016310010310.5005/jp-journals-10081-14366Rare Presentation of Neonatal Necrotizing Fasciitis: Case Series and Review of LiteratureKruti N Shah0https://orcid.org/0000-0002-4506-4601Shwetal Bhatt1Dipal Zanzrukriya2Salesh K Soni3Kruti N Shah, Department of Pediatrics, Government Medical College Baroda, Vadodara, Gujarat, India, Phone: +91 8780527050Department of Pediatrics, Government Medical College Baroda, Vadodara, Gujarat, IndiaDepartment of Pediatrics, Government Medical College Baroda, Vadodara, Gujarat, IndiaDepartment of Plastic and Cosmetic Surgery, Government Medical College Baroda, Vadodara, Gujarat, IndiaAims and background: Necrotizing fasciitis is a rare, severe, fulminating disorder infecting all the layers of skin and extending to the fascial planes and muscular layer. It is an unusual presentation of septicemia in neonates and is, to a larger extent, a disease of immunocompromised adults. Thus, there is a lack of reported neonatal cases. It could be misdiagnosed as cellulitis or myonecrosis due to its nonspecific presentations. It becomes essential to diagnose in a timely manner and culminate in a multidisciplinary approach with antimicrobial treatments and surgical aid to prevent its fulminating course. Thus, we aim to report three cases of necrotizing fasciitis presented in neonatal age, presented to us within a short span of 6 months, and sensitize its neonatal presentation with distinct clinical features. Case description: We report three cases of necrotizing fasciitis presented in neonatal age with varied clinical features, presenting as deep ulcers with fasciitis and scalp abscesses with no history of perinatal infections. The wound culture may not necessarily be septic. However, a multidisciplinary approach involving broad-spectrum intravenous antimicrobial therapy with advanced plastic surgical methodologies can help attenuate its fulminant course. Timely diagnosis and prompt intervention may aid in complete recovery, as in our cases, and thus prevent fatality. Conclusion: Neonatal necrotizing fasciitis is a progressive, fulminating infection of the skin, subcutaneous tissues, and fascial planes and may extend to muscular levels. We aim to sensitize the presence of necrotizing fasciitis as an unusual presentation of neonatal septicemia, encourage prompt diagnosis, and adopt a multidisciplinary approach. Clinical significance: Neonatal necrotizing fasciitis, though infrequent, carries a fatal, fulminating course. It is primarily a polymicrobial infection involving deep skin layers with extension to muscular planes. The diagnosis is usually clinical. Timely diagnosis with prompt antimicrobial treatment and surgical intervention helps reduce grave complications and mortality rates.https://www.pidjournal.com/doi/PID/pdf/10.5005/jp-journals-10081-1436case reportneonatalnecrotizing fasciitissepsisskin grafting
spellingShingle Kruti N Shah
Shwetal Bhatt
Dipal Zanzrukriya
Salesh K Soni
Rare Presentation of Neonatal Necrotizing Fasciitis: Case Series and Review of Literature
Pediatric Infectious Disease
case report
neonatal
necrotizing fasciitis
sepsis
skin grafting
title Rare Presentation of Neonatal Necrotizing Fasciitis: Case Series and Review of Literature
title_full Rare Presentation of Neonatal Necrotizing Fasciitis: Case Series and Review of Literature
title_fullStr Rare Presentation of Neonatal Necrotizing Fasciitis: Case Series and Review of Literature
title_full_unstemmed Rare Presentation of Neonatal Necrotizing Fasciitis: Case Series and Review of Literature
title_short Rare Presentation of Neonatal Necrotizing Fasciitis: Case Series and Review of Literature
title_sort rare presentation of neonatal necrotizing fasciitis case series and review of literature
topic case report
neonatal
necrotizing fasciitis
sepsis
skin grafting
url https://www.pidjournal.com/doi/PID/pdf/10.5005/jp-journals-10081-1436
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AT dipalzanzrukriya rarepresentationofneonatalnecrotizingfasciitiscaseseriesandreviewofliterature
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