Diagnostic Challenge of Necrotizing Soft Tissue Infection in a Patient With B Lymphocytic Leukemia

Abstract

The necrotizing soft tissue infection is a rare surgical emergency. Early diagnosis and timely treatment can contribute to better survival and the preservation of the limb. Diagnosis of this pathology remains a challenge to the clinician at the initial stage of the disease, especially if the patient is immunocompromised. We present the case of a 75-year-old man with B lymphocytic leukemia who was diagnosed with necrotizing soft tissue infection but failed to exhibit typical clinical and laboratory measurements. This case highlights the difficulty of early diagnosis in hematology patient, altered sensitivity of disease-specific scoring systems, and importance of high clinician awareness.

Keywords: immunocompromised patient; lrinec score; medical emergency; necrotizing fasciitis.

Figure 1. Erythematous region around the posterior surface of the right calf

Figure 2. Erythematous region on the medial surface of the right thigh

Figure 3. Necrotic greyish fascia in the posterior aspect of the wound