Fulminantni nekrotizirajući fasciitis sa sindromom toksičnog šoka i višestrukim zatajenjem organa uzrokovan streptokokom grupe A (GAS): prikaz slučaja

Necrotizing fasciitis (NF) commonly known as the “flesh eating disease” is a rare and threatening life disease which is often misdiagnosed on admission. Caused by group A streptococcus (GAS), NF can lead to streptococcal toxic shock syndrome with multiple organ failure and high mortality rate (30%-70%) in spite of aggressive treatment. We present a case of a young woman who was admitted to hospital and primarily diagnosed as acute appendicitis on admission. After explorative laparotomy which showed no sign of acute abdominal illness, pale skin lesion proposing as cellulitis, on her right leg was noticed. In the next 6 hours she developed toxic shock with rapid progression of the soft tissue necrosis.Nekrotizirajući fasciitis (NF) poznat kao "bolest koja jede meso" rijetka je i životno ugrožavajuća bolest koja se, pri prijemu u bolnicu, često pogrešno dijagnosticira. Nekrotizirajući fasciitis uzrokovan streptokokom grupe A (GAS) može, unatoč agresivnom liječenju, dovesti do streptokoknog sindroma toksičnog šoka s višestrukim zatajenjem organa visoke stope smrtnosti (30% -70%). Opisujemo slučaj mlade žene koja je primljena u bolnicu i primarno dijagnosticirana kao akutna upala slijepog crijeva. Nakon laparotomije koja nije pokazala znakove akutne bolesti abdomena, primijećena je blijeda lezija kože desne noge te se posumnjalo na celulitis. U idućih 6 sati u bolesnice se razvio toksični šok s brzim napredovanjem nekroze mekog tkiva

Fulminantni nekrotizirajući fasciitis sa sindromom toksičnog šoka i višestrukim zatajenjem organa uzrokovan streptokokom grupe A (GAS): prikaz slučaja

Necrotizing fasciitis (NF) commonly known as the “flesh eating disease” is a rare and threatening life disease which is often misdiagnosed on admission. Caused by group A streptococcus (GAS), NF can lead to streptococcal toxic shock syndrome with multiple organ failure and high mortality rate (30%-70%) in spite of aggressive treatment. We present a case of a young woman who was admitted to hospital and primarily diagnosed as acute appendicitis on admission. After explorative laparotomy which showed no sign of acute abdominal illness, pale skin lesion proposing as cellulitis, on her right leg was noticed. In the next 6 hours she developed toxic shock with rapid progression of the soft tissue necrosis.Nekrotizirajući fasciitis (NF) poznat kao "bolest koja jede meso" rijetka je i životno ugrožavajuća bolest koja se, pri prijemu u bolnicu, često pogrešno dijagnosticira. Nekrotizirajući fasciitis uzrokovan streptokokom grupe A (GAS) može, unatoč agresivnom liječenju, dovesti do streptokoknog sindroma toksičnog šoka s višestrukim zatajenjem organa visoke stope smrtnosti (30% -70%). Opisujemo slučaj mlade žene koja je primljena u bolnicu i primarno dijagnosticirana kao akutna upala slijepog crijeva. Nakon laparotomije koja nije pokazala znakove akutne bolesti abdomena, primijećena je blijeda lezija kože desne noge te se posumnjalo na celulitis. U idućih 6 sati u bolesnice se razvio toksični šok s brzim napredovanjem nekroze mekog tkiva

Acute descending necrotizing mediastinitis as a complication of the retropharyngeal abscess caused by anaerobes

Descending necrotizing mediastinitis (DNM) is a rare, life-threatening form of mediastinitis caused by odontogenic, pharyngeal, or cervical infections. The retropharyngeal space is the most common primary site of infection. Given the fulminant course and high mortality rate, early diagnosis and prompt treatment are important predictors of survival in patients with DNM. Appropriate empirical antibiotic treatment, prompt surgical intervention, and proper management of patients in the intensive care unit can be of vital importance. We present the case of a previously healthy 20-year-old male patient who was successfully cured and discharged from the Clinical Center University of Sarajevo after suffering from a severe form of mediastinitis as a complication of the retropharyngeal abscess caused by anaerobes