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A woman with spreading erythema after caesarean section
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Journal Article
A woman with spreading erythema after caesarean section
2020
Overview
Correspondence to A Pouncey anna.pouncey@gmail.com A 26 year old woman presented to the emergency department six days after having a caesarean section with an area of spreading erythema extending from her wound site over the infra-umbilical abdomen (fig 1). Ecchymosis (a result of tissue necrosis and capillary breakdown), rapidly spreading cellulitis, and pain out of proportion are highly suggestive1 of necrotising fasciitis, which is a surgical emergency. Mortality in necrotising fasciitis ranges from 8% to 76%.5 Appropriate treatment has been associated with a decrease in mortality (10%-40%)6; however, mortality is higher if there is shock and end organ damage (50% to 70%).7 Learning points Consider necrotising fasciitis when moderate to severe cellulitis is present at any location on the body, especially if the patient has had recent surgery or trauma, or has anaemia, diabetes, obesity, immunosuppression, malnutrition, hypertension, or peripheral vascular disease.
Publisher
BMJ Publishing Group LTD
Subject
/ Adult
/ Anemia
/ Anti-Bacterial Agents - therapeutic use
/ Diabetes
/ Erythema
/ Fasciitis, Necrotizing - diagnosis
/ Fasciitis, Necrotizing - pathology
/ Fasciitis, Necrotizing - therapy
/ Female
/ Humans
/ Pain
/ Puerperal Disorders - diagnosis
/ Puerperal Disorders - pathology
/ Puerperal Disorders - therapy
/ Surgery
/ Surgical Wound Infection - diagnosis
/ Surgical Wound Infection - pathology
/ Surgical Wound Infection - therapy
/ Trauma
