Abstract
Author(s): Sahadete Shala, Merita Krasniqi, Brikene Elshani, Astrit M.Gashi*, Jehona Luta, Besa Selimi and Gent Haxhikadrija
Background: Necrotizing fasciitis (NF) is a rare but potentially life-threatening infection that primarily affects subcutaneous fascia, with rapid spread to surrounding tissues. In this retrospective case study, we investigated the clinical presentation, management, and outcomes of NF in a 28-year-old primipara with multiple risk factors, including type I obesity, poorly controlled diabetes, hypothyroidism, a history of recurrent abortions, and an allergic reaction to Cephalosporins, who developed NF following a scheduled cesarean delivery.
Methods: Detailed medical records were retrieved, including pre-operative, perioperative, and postoperative data. Microbiological data from wound cultures and antibiotic sensitivity patterns were analyzed.
Results: The patient presented with erythema and tenderness above the suprapubic operative wound on the 7th postoperative day. Urgent necrectomy, radical debridement, and hemostasis were performed, with positive wound cultures for Streptococcus agalactia gr. B. Subsequent microbiological analysis revealed Acinetobacter baumannii, sensitive only to Colistin. Treatment with Colistin led to successful eradication of the infection and formation of granulation tissue. The patient was discharged from the hospital in good physical condition after appropriate counseling and therapy.
Conclusions: This case study sheds light on the clinical course and management of NF in high-risk obstetric patients following cesarean delivery. Prompt recognition, early surgical intervention, and targeted antibiotic therapy were crucial for successful treatment. Further research is needed to improve early detection and treatment strategies for NF in obstetric patients with multiple risk factors. The findings emphasize the importance of vigilance in identifying NF in postoperative patients and implementing timely and appropriate interventions to achieve positive outcomes.