case_images: PMC10583506_01
case_images: At admission, the patient presented with a very rapidly worsening swelling of the left lower leg with already partially necrotic areas.
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case_images: PMC10583506_01_10.1177_2050313X231207202-fig1.jpg
case_images: fig1-2050313X231207202
case_images: The patient had been experiencing progressive pain and swelling of the right lower extremity with permanent redness and petechial haemorrhage for a week (Figure 1), both of which had worsened extremely since the morning.
case_images: Wound debridement and fasciotomy were performed at the right lower leg. This photograph was taken after the procedure on the first day after admission to the intensive care unit.
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case_images: Computer tomography of the right knee and lower leg: (a) axial view and (b) sagittal view. Note the perifascial air along the gastrocnemius muscle (arrow) and the large circumferential skin defects (arrowhead).
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case_images: fig3-2050313X231207202
case_images: These CT scans showed an elongated subcutaneous fluid retention of the right thigh down to the level of the upper ankle with small air bubbles along the fascia of the medial head of the gastrocnemius muscle (Figure 3).
case_images: Pathology. (a) Overview of the resection specimen showing extensive necrosis involving the fascia and the perifascial soft tissue (fascia seen as an eosinophilic band at a lower field). (b) Higher magnification shows necrosis and extensive neutrophilic inflammation with entrapped fascia fragments in the midfield.
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case_images: PMC10583506_01_10.1177_2050313X231207202-fig4.jpg
case_images: fig4-2050313X231207202
case_images: Pathologic findings confirmed severe necrotising florid inflammation consistent with necrotising fasciitis (Figure 4).