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case_images: Fat-saturated T2-weighted magnetic resonance images. (A) Coronal view, (B) axial view, and (C) sagittal view.
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case_images: Magnetic resonance imaging of the left lower leg revealed bone marrow edema in the tibial plateau, multiple swollen muscle groups with intermuscular fluid suggesting an infectious process, and effusion in the left knee joint (Figure 1).
case_images: Intraoperative findings. (A) Extensive necrosis and exudation of the skin in the upper and middle segments of the left lower leg. (B) Post-excision, superficial venous thrombosis and necrotizing fasciitis with extensive muscle necrosis were observed, and they were most pronounced in the anterior tibial compartment. (C) Following thorough debridement, bleeding was controlled, and the wound was covered with a vacuum sealing drainage dressing for continuous drainage.
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case_images: Under general anesthesia, emergency debridement was performed, and the wound was covered with a vacuum sealing drainage (VSD) dressing for continuous drainage (Figure 2).
case_images: Culture and pathological findings. (A and B) Culture: exudates cultured on Sabouraud dextrose agar and potato dextrose agar at 26-28 C for 3 days, revealing colonies that transitioned from white or gray to gray or brown with a dense, fluffy, cotton-like appearance. (C) Smear: rhizoids (beneath the mycelium), smooth hyphae (few or no septa), upright sporangia with spherical, smooth-walled sporangiospores. (D) Pathological findings: extensive necrosis and abundant fungal hyphae in tissue with positivity on periodic acid-Schiff and periodic acid-methenamine silver staining, indicating Rhizopus spp.
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case_images: Additionally, Rhizopus spp. were isolated from the intraoperative pus culture (+++, Figure 3). 
case_images: Observations before debridement and vacuum sealing drainage (June 19 and 24). (A) On June 19, previously intact skin and muscle deteriorated with expanded necrosis and complete loss of the anterior tibial muscles. (B) By June 24, necrosis had progressed to the knee with severe involvement of the anterior tibial muscles.
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case_images: On June 19 and 24, he underwent additional debridement and VSD drainage (Figure 4).
case_images: Hospital discharge (July 2). Prior to discharge, the vacuum sealing drainage was removed, revealing well-formed granulation tissue and no evidence of further necrotic progression.
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case_images: Finally, he was discharged on July 2 because of financial constraints (Figure 5).
case_images: Timeline of the patient's course prior to and during hospitalization.
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case_images: Figure 6 outlines the timeline of the case presentation and treatment course to aid in understanding the progression.