A rare presentation of necrotising fasciitis and myositis with femoral head necrosis

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Abstract  Necrotising fasciitis is a rapidly progressive, polymicrobial synergistic soft tissue infection that spreads along fascial
planes beneath seemingly normal skin. The relatively benign appearance of the extremity is misleading and often results in
delay in diagnosis and increased morbidity or death. Involvement of bone is not a recognised feature. Successful management
requires early detection, radical surgical debridement and broad spectrum intravenous antibiotics. We report an unusual case
of necrotising fasciitis in a 61-year-old male who presented with musculoskeletal symptoms and gas within the femoral head
as well as surrounding soft tissues. This resulted in necrosis of the femoral head with the development of chronic osteomyelitis,
requiring long-term antibiotics and ultimately proximal femoral excision. We describe a previously unreported presentation
of this condition with musculoskeletal involvement and discuss the potential pitfalls in delayed diagnosis.

Content Type Journal ArticleCategory Case ReportDOI 10.1007/s00238-008-0221-7Authors
Mathew David Sewell, The Royal London Hospital Department of Plastic and Reconstructive Surgery London UKSwee Chai Ang, The Royal London Hospital Department of Trauma and Orthopaedic Surgery London UKHasu Patel, The Royal London Hospital Department of Plastic and Reconstructive Surgery London UKGareth Scott, The Royal London Hospital Department of Trauma and Orthopaedic Surgery London UK



Journal European Journal of Plastic SurgeryOnline ISSN 1435-0130Print ISSN 0930-343X (Source: European Journal of Plastic Surgery)
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