Necrotizing fasciitis and hypothyroidism

摘要

A 51-year-old man was admitted to hospital with extensive cellulites, dermal excoriation, and a deep-seated abscess in the skin over the perineum, extending dorsally over the lower back. Urgent surgical exploration and debridement was undertaken, which revealed extensive necrotizing fasciitis. Further management consisted of high-dose intravenous antibiotics and debridement (on six different occasions, including the lower abdominal wall, penile tissue, perineal tissue extending to the back, perianal and large areas of lumbar skin, overall approximately 18% of body surface area). The wound was regularly cleaned and dressed with Betadine (iodine)-soaked gauzes. In view of the large open wound dressed with iodine soaks, concern was raised about the possible absorption of iodine through the large surface area, and the potential for this to accumulate in the thyroid gland (the main iodine reserve of the body).