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Case Reports
. 2020 Aug 15:29:100353.
doi: 10.1016/j.tcr.2020.100353. eCollection 2020 Oct.

Subcutaneous emphysema or necrotizing fasciitis after insect bite?

Nazım Karahan  1 , Ahmet Oztermeli  2
Affiliations
Case Reports

Subcutaneous emphysema or necrotizing fasciitis after insect bite?

Nazım Karahan et al. Trauma Case Rep. .

Erratum in

Abstract

Background: The rapid form of subcutaneous emphysema after an insect bite is hard to distinguish from necrotizing fasciitis.

Case presentation: Here we report a case of benign subcutaneous emphysema after an insect bite on the hand of an 18-year-old Caucasian man. The puncture area in the first web space of his hand was erythematous and swollen. After 4 h, he began to hear crackling sounds in the hand. Although conservative management was provided, he experienced gradually increasing pain and rapid progression in swelling and crepitation. The symptoms regressed after fasciotomy.

Conclusion: This is the fourth reported case of benign subcutaneous emphysema after an insect bite in the literature. Although benign emphysema has a good prognosis after treatment, it is similar to necrotizing fasciitis. Proper diagnosis can only be established with histological and microbiological investigations, but in cases where early histological and microbiological investigations cannot be performed, biochemistry and radiological test should be used.

Keywords: Insect bite; LNIREC; Necrotizing fasciitis; Subcutaneous emphysema.

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Conflict of interest statement

The author, their immediate family, and any research foundation with which they are affiliated have not received any financial payments or other benefits from any commercial entity related to the subject of this article and no funding was received related to the subject of this article. We have no conflict of interest to declare.

Figures

Fig. 1
Fig. 1
Black arrow showing the puncture side.
Fig. 2
Fig. 2
AP forearm radiograph with black arrows showing the gas formation in the subcutaneous and the intermuscular planes.
Fig. 3
Fig. 3
Intraoperative image of the patient showing no discoloration and necrosis.
Fig. 4
Fig. 4
a: Lateral picture of left elbow and forearm; b: AP view of forearms and wrists demonstrating a full range of motion.
See this image and copyright information in PMC

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