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Case Reports
. 2021 Mar 27;13(3):e14139.
doi: 10.7759/cureus.14139.

Legal Tattoo Complicated by Sepsis and Necrotizing Fasciitis Requiring Acute Surgery

Simona Uggeri  1 , Francesca Nasi  2 , Marco Ghidoni  1 , Fabio Gilioli  1 , Novella Guicciardi  2
Affiliations
Case Reports

Legal Tattoo Complicated by Sepsis and Necrotizing Fasciitis Requiring Acute Surgery

Simona Uggeri et al. Cureus. .

Abstract

A previously healthy 26-year-old male was referred to our hospital for fever occurring after getting a tattoo on the left leg. At the emergency department, he was promptly diagnosed with sepsis and necrotizing fasciitis of the left leg. The patient was empirically treated with vancomycin and piperacillin/tazobactam. Blood cultures identified Streptococcus pyogenes. Necrotizing fasciitis required acute surgery. The patient survived as a result of an early clinical diagnosis and surgical intervention. We report the first case of sepsis and severe soft tissue infection, after legal tattooing, which required fasciotomy. All previously reported cases have been about necrotizing fasciitis in young males who received traditional Samoan tattooing, a practice usually realized with handmade tools. In our patient, the tattoo, created in Samoan style, was performed in an authorized center by a professional tattooist using contemporary sanitary techniques.

Keywords: necrotizing fasciitis; sepsis; streptococcus pyogenes; tattooing.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Erythema and edema along several areas of the tattooed skin.
Figure 2
Figure 2. Arterial-phase CT axial images show circumferential edema of subcutaneous tissue, thickening of the crural fascia, and fluid flap on the medial side of leg, close to gastrocnemius muscle belly.
CT, computed tomography
Figure 3
Figure 3. CT axial imaging: after surgery, edematous thickening of subcutaneous tissue appeared along the leg. Under the surgical metal clips, an intrafascial hydro-aerial collection is visible.
CT, computed tomography
See this image and copyright information in PMC

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