case_images: PMC11329950_01
case_images: Right-sided vulvar bulge and green-black discoloration, necrotizing fasciitis from labia major since posterior glutea (a, b) peri-anal wound with necrotic patch and slough.
case_images: 10.1177_2050313X241271829-fig1.jpg
case_images: PMC11329950_01_10.1177_2050313X241271829-fig1.jpg
case_images: fig1-2050313X241271829
case_images: Examination revealed a significant perineal wound extending from the gluteal area to the right labia majora, characterized by foul-smelling discharge and necrosis, suggestive of necrotizing fasciitis or gangrene (Figure 1(a) and (b)). Despite appearing well-nourished, she was pallor, disoriented, and uncooperative, with severe hypotension and bradycardia (Figure 1).
case_images: Extensive debridement of the necrotic tissue preserving the anal sphincter. Intraoperatively, wound seen extending to the ischiorectal fossa.
case_images: 10.1177_2050313X241271829-fig2.jpg
case_images: PMC11329950_01_10.1177_2050313X241271829-fig2.jpg
case_images: fig2-2050313X241271829
case_images: Emergency surgical debridement preserved the anal sphincter but revealed a deep fascial plane infection (Figure 2).
case_images: Intensive dressing. Despite 24-h dressings, after 3 weeks of intensive management, granulation tissue started to appear on the wound site (Figure 4).
case_images: 10.1177_2050313X241271829-fig3.jpg
case_images: PMC11329950_01_10.1177_2050313X241271829-fig3.jpg
case_images: fig3-2050313X241271829
case_images: Despite these preventive measures, the patient developed pneumonia, which was aggressively treated with targeted antibiotics and supportive respiratory care (Figure 3).
case_images: Granulation tissue started to appear on the wound site.
case_images: 10.1177_2050313X241271829-fig4.jpg
case_images: PMC11329950_01_10.1177_2050313X241271829-fig4.jpg
case_images: fig4-2050313X241271829
case_images: Granulation tissue started forming at the wound site after 3 weeks (Figure 4).
case_images: The wound was not closed and recurrent infection on the buttocks.
case_images: 10.1177_2050313X241271829-fig5.jpg
case_images: PMC11329950_01_10.1177_2050313X241271829-fig5.jpg
case_images: fig5-2050313X241271829
case_images: Histology confirmed Fournier's syndrome (Figure 5).