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Gaceta Médica Espirituana

On-line version ISSN 1608-8921

Abstract

RONDON MADRIGAL, Egduina A.; RAMOS LAGE, Miladys; PULIDO ESPINOSA, Cosme D.  and  JIMENEZ RONDON, Erick D.. Necrotizing fasciitis due to Enterococcus gallinarum in a pospartum patient. Case report. Gac Méd Espirit [online]. 2021, vol.23, n.3, pp.132-141.  Epub Dec 03, 2021. ISSN 1608-8921.

Background:

Necrotizing fasciitis is an infection that develops rapidly, affecting the skin, subcutaneous cellular tissue, superficial fascia and sometimes deep fascia, in surgical wounds by producing hystenotic necrosis and severe systemic toxicity. It is a supplementary systemic affectation, which in turn is associated with endogenous predisposing factors such as: diabetes mellitus, obesity, alcoholism, HIV infection, and exogenous: gynecobstetric surgery, injections, traumatisms; so these patients are critical patients in intensive care units, with a non-uniform clinical progression, leading to a fulminant evolution when parallel to the hyperacute or fulminant variant.

Objective:

To describe the presence of hyperacute necrotizing fasciitis caused by Enterococcus gallinarum in a puerperal.

Case report:

A puerperal who suffered from dystocia delivery by elective cesarean section at 38.3 weeks, at 24 h presented general manifestations accompanied by skin lesions; she underwent gynecobstetric surgery, her evolution was torpid and she died of multiorgan failure after 3 days due to the consequences of hyperacute or fulminant necrotizing fasciitis, caused by Enterococcus gallinarum.

Conclusions:

Necrotizing fasciitis is a rare and fatal disease if not treated in time; its diagnosis is difficult in its early phase because it is often clinical. Surgical treatment should be urgent and combined with systemic antibiotic therapy due to the causative germ and the toxicity they produce.

Keywords : Necrotizing fasciitis; puerperal infection; dystocia cesarean delivery.

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