From a pimple to a crater.

摘要

In January, 2010, a 31-year-old woman was transferred to our intensive care unit with multiorgan failure, severe inflammatory response syndrome, and the working diagnosis of necrotising fasciitis. 2 weeks before admission she had presented to another hospital with a purulent ulcer that had started as a single painful pustule of the left leg. The lesion measured 4x4 cm and was surrounded by extensive reddening and induration of the adjacent skin (see webappendix). Antibiotic treatment was started with amoxicillin/clavulanic acid and surgical debridement was done. After surgery, there was rapidly progressive inflammation of the local site and worsening of her general condition. MRI of the left leg showed fascial thickening and hyperintense T2-weighted signal suggestive of necrotising fasciitis. Despite repeat surgery of the left leg she went into shock and was then transferred to our university hospital.