Necrotizing Fasciitis of the Forearm in a 20-Week Pregnant Woman: Case Report and Literature Review.

Andreea Mironică, Bogdan Ioncioaia, Botond Janko, George Călin Dindelegan, Alexandru Ilie-Ene, Lucia-Ioana Furcovici, Balazs Sarkadi, Claudiu Ioan Filip
Author Information
  1. Andreea Mironică: Faculty of Medicine, University of Medicine "Iuliu Hatieganu" Cluj-Napoca, 1st Surgical Clinic, County Emergency Hospital, Street Clinicilor 3-5, 400347 Cluj-Napoca, Romania. ORCID
  2. Bogdan Ioncioaia: 1st Surgical Clinic, County Emergency Hospital, Street Clinicilor 3-5, 400347 Cluj-Napoca, Romania.
  3. Botond Janko: 1st Surgical Clinic, County Emergency Hospital, Street Clinicilor 3-5, 400347 Cluj-Napoca, Romania.
  4. George Călin Dindelegan: Faculty of Medicine-6th Dept, 1st Surgery Clinic, "Iuliu Hațieganu" University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania. ORCID
  5. Alexandru Ilie-Ene: Faculty of Medicine, University of Medicine "Iuliu Hatieganu" Cluj-Napoca, 1st Surgical Clinic, County Emergency Hospital, Street Clinicilor 3-5, 400347 Cluj-Napoca, Romania. ORCID
  6. Lucia-Ioana Furcovici: 1st Surgical Clinic, County Emergency Hospital, Street Clinicilor 3-5, 400347 Cluj-Napoca, Romania.
  7. Balazs Sarkadi: 1st Surgical Clinic, County Emergency Hospital, Street Clinicilor 3-5, 400347 Cluj-Napoca, Romania.
  8. Claudiu Ioan Filip: Faculty of Medicine-6th Dept, 1st Surgery Clinic, "Iuliu Hațieganu" University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania. ORCID

Abstract

Necrotizing fasciitis (NF) is a rare skin and soft tissue infection that progresses rapidly to necrosis and can be life-threatening. The incidence varies by geographic region but is generally low, with a mortality rate ranging between 11 and 22%. Early diagnosis and treatment are crucial for survival, particularly in patients with underlying conditions such as immune suppression, diabetes, obesity, trauma, recent surgical procedures, or renal pathology. However, the relationship between pregnancy and NF has not been extensively studied. The case presented involves a 37-year-old, 20-week pregnant woman, who presented to the emergency department with septic shock and left forearm compartment syndrome. She reported no recent trauma or obvious source of contamination. The patient was immediately admitted and taken to the operating room. During admission, she underwent three surgeries, consisting of staged debridement, fasciectomy, and vacuum therapy and skin grafting. The patient was carefully monitored in the intensive care unit and multiple obstetrical consultations were performed to monitor the fetus. The patient was discharged with a fully integrated graft and with the donor area undergoing epithelialization. This case highlights the importance of early diagnosis and treatment of NF, particularly in high-risk patients, and the need for further research into the relationship between pregnancy and NF.

Keywords

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