Background: Necrotizing fasciitis caused by Aspergillus flavus is extraordinarily rare, with most cases observed in immunocompromised patients. We report a case in an immunocompetent young patient and review the literature. Methods: We present a case of limb-necrotizing fasciitis caused by Aspergillus flavus and conducted a systematic PubMed search using keywords related to “Aspergillus flavus”, “soft tissue infection” and “necrotizing fasciitis” to identify previously reported cases. Results: A 26-year-old man presented with progressive swelling and numbness of the right forearm originating from a minor abrasion. Surgical debridement and fungal cultures confirmed Aspergillus flavus infection. The patient was successfully treated with voriconazole. Notably, severe local signs contrasted with nearly normal systemic inflammatory indices throughout the disease course. Literature review identified 8 reports encompassing 10 patients; 7 were immunocompromised. Non-facial Aspergillus flavus soft tissue infections were exceedingly rare, with only two cases in immunocompromised hosts and one in an immunocompetent patient following trauma. Conclusion: We report the youngest immunocompetent patient with limb necrotizing fasciitis caused by Aspergillus flavus . This case highlights the discrepancy between local signs and systemic response. Timely intervention is crucial for favorable prognosis. Keywords: necrotizing fasciitis, soft tissue infection, Aspergillus flavus , voriconazole, fasciotomy
Sun et al. (Wed,) studied this question.