J Korean Burn Soc.  2023 Dec;26(2):48-53. 10.47955/jkbs.23.0006.

A Case of Necrotizing Fasciitis in an Uncontrolled Diabetic Alcoholic with a Small Untreated Wound

• Bang CY
• Lee SH
• Oh SJ
• Lee SY
• Jeong C
• Sung KY

• KMID: 2549012
• DOI: http://doi.org/10.47955/jkbs.23.0006

Abstract

Necrotizing fasciitis is a deep soft tissue infection that includes the muscle fascia and subcutaneous fat. It is rare, but it causes necrosis of the muscle, fascia, and subcutaneous tissues. It advances quickly and becomes a life-threatening bacterial infection with high morbidity and mortality. Alcoholics with diabetes are especially vulnerable to necrotizing fasciitis and at high risk of progression to severe sepsis and septic shock. In that sense, early diagnosis and prompt treatment are important in the management of necrotizing fasciitis, especially in diabetic alcoholics. We recently treated necrotizing fasciitis on the left lower leg of a 55-year-old diabetic alcoholic who had not controlled blood sugar for 4 years. In our case, a minor burn wound on the left lower leg caused by the hot ramen soup progressed to necrotizing fasciitis within ten days. The patient who was diagnosed with necrotizing fasciitis of the left lower leg was successfully managed with prompt diagnosis, serial debridement, and a split-thickness skin graft while controlling blood sugar levels.

Keyword

Necrotizing fasciitis; Lower extremity; Alcoholic use disorder; Uncontrolled diabetes; Minor burn