Fascite necrotizzante: caso clinico

  • Giovanni Petracca | doc37@virgilio.it Dipartimento di Chirurgia Generale, Ospedale G. Jazzolino, Vibo Valentia, Italia. https://orcid.org/0000-0002-8016-6910
  • Francesco Zappia Dipartimento di Chirurgia Generale, Ospedale G. Jazzolino, Vibo Valentia, Italia.
  • Giuseppe Maccarone Dipartimento di Chirurgia Generale, Ospedale G. Jazzolino, Vibo Valentia, Italia.

Abstract

La Fascite Necrotizzante (FN) è un’infezione dei tessuti molli caratterizzata da un’estesa necrosi del tessuto adiposo sottocutaneo, delle strutture neurovascolari e della fascia. La caratteristica del caso clinico da noi trattato è stata l’aggressività e la rapida progressione della malattia. Una donna di 59 anni giungeva alla nostra osservazione in condizioni molto gravi con febbre e un’estesa area necrotica maleodorante in regione inguino-femorale destra con estensione alla coscia. In anamnesi nessuna patologia pregressa. Obesità. La minima cellulite cutanea presente all’esordio della malattia avrebbe potuto causare un ritardo nella diagnosi e ciò avrebbe potuto determinare una rapida progressione della malattia verso lo shock, l’insufficienza multiorgano e, in ultima analisi, la morte. La tomografia computerizzata e la risonanza magnetica possono essere utili nei casi in cui i segni sono dubbi o la diagnosi è incerta. Presenteremo di seguito una revisione dettagliata della letteratura e descriveremo le attuali modalità di trattamento. Nel caso in questione, lo sbrigliamento chirurgico aggressivo, la gestione medica della sepsi e delle comorbidità e la tempestiva chiusura della ferita mediante innesto dermo-epidermico sono stati fondamentali per un esito favorevole della patologia. La FN è una rara infezione dei tessuti molli pericolosa per la vita che si diffonde rapidamente e progressivamente lungo la fascia profonda. La prognosi dipende da una diagnosi accurata e da un trattamento immediato.

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Pubblicato
2021-07-30
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Case Reports
Parole chiave:
Fascite necrotizzante, shock, innesto di cute, case report
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Come citare
Petracca, G., Zappia, F., & Maccarone , G. (2021). Fascite necrotizzante: caso clinico. Italian Journal of Wound Care, 5(2). https://doi.org/10.4081/ijwc.2021.60