Necrotizing fasciitis (NF) is a rapidly progressive, life-threatening soft tissue infection characterized by widespread fascial necrosis, systemic toxicity, and high mortality without prompt surgical intervention. Emphysematous pyelonephritis (EPN) is a rare necrotizing infection of the kidney and perirenal tissues caused by gas-producing microbes, most often Escherichia coli, in patients with uncontrolled diabetes mellitus. We report the case of a 69-year-old man who developed NF with contiguous EPN. Despite aggressive surgical and medical management, he rapidly progressed to refractory septic shock and multi-organ failure, ultimately resulting in death. This case highlights the importance of early recognition of NF and determining its underlying cause, as delays in intervention may lead to uncontrollable sepsis.
Rose et al. (Tue,) studied this question.