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2022, Number 6

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Acta Pediatr Mex 2022; 43 (6)

Aggressive management of necrotizing fasciitis in cancer patients: a case report

Hernández-Arrazola D, Santiago-Montor MÁ, Shalkow-Klincovstein J, Echeverria-Vargas L, Díaz-Machorro R, Lara-Blanco M

Language: Spanish
References: 13
Page: 347-352
PDF size: 294.93 Kb.


ABSTRACT

Background: Necrotizing fasciitis is a rare infection in pediatrics with high mortality, it accounts for 0.03% of the causes of hospitalization in children, the cornerstone of treatment is surgical, through debridement as well as the early administration of antibiotics.
Clinical case: 5-year-old female, with a one-month history characterized by fever, adenopathy, asthenia, adynamia and petechiae; Presents hematic biometry with pancytopenia, for which a bone marrow aspiration is performed with a diagnosis of acute lymphoblastic leukemia, a steroid window begins, presenting on the seventh day a rapidly progressive lesion in the right leg, evolving with blisters and necrosis which compromises skin, subcutaneous cellular tissue and gastrocnemius muscle; For this reason, aggressive surgical management was decided; she is currently in the remission induction phase with a remitted right leg injury.
Conclusions: Necrotizing fasciitis is a medical and surgical emergency, in patients with oncological pathology it presents a rapid progression given their acquired immunosuppression, aggressive surgical treatment must be established before 24 hours of initiation to improve the prognosis and reduce mortality.


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