https://doi.org/10.4081/ecj.2023.11046

A rapidly progressive painful skin lesion

Vol. 19 No. 1 (2023)
Published: 28 March 2023
Streptococcus pyogenes, necrotizing fasciitis, skin necrosis, soft tissue infection, necrotizing cellulites, streptococcal gangrene
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Authors

Erika Poggiali
E.Poggiali@ausl.pc.it
Emergency Department, Guglielmo da Saliceto Hospital, Piacenza, Italy.
Giovanni Santilli
Emergency Department, Guglielmo da Saliceto Hospital, Piacenza, Italy.
Andrea Vercelli
Emergency Department, Guglielmo da Saliceto Hospital, Piacenza, Italy.

A 48-year-old woman presented to our emergency department with fever and a severe painful erythematous and ecchymotic skin lesion on the third finger of the left hand, that rapidly evolved into haemorrhagic bullae with diffuse swelling and edema of all her left hand, associated with the onset of lymphangitis in her left arm and crescendo-like pain. She denied trauma or insect bite. Her past medical history was unremarkable, except for chilblains with no sequelae. She did not take any medication. She was not a smoker. Laboratory tests showed neutrophilic leucocytosis (WBC 15,000/mm3; N 14,500/mm3), a slight thrombocytopenia (139,000/mm3), elevated C-reactive protein (12 mg/dL, normal value <0.5), increased procalcitonin (1.3 ng/mL, normal value < 0.5) and transaminases (AST 64 U/L; ALT 70 U/L, normal value 0-31). HIV was excluded.

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Europe PMC
Chen LL, Fasolka B, Treacy C. Necrotizing fasciitis: A comprehensive review. Nursing 2020;50:34-40. DOI: https://doi.org/10.1097/01.NURSE.0000694752.85118.62
Misiakos EP, Bagias G, Patapis P, et al. Current concepts in the management of necrotizing fasciitis. Front Surg. 2014;1:36. DOI: https://doi.org/10.3389/fsurg.2014.00036
Lancerotto L, Tocco I, Salmaso R, Vindigni V, Bassetto F. Necrotizing fasciitis: classification, diagnosis, and management. J Trauma Acute Care Surg 2012;72:560-6. DOI: https://doi.org/10.1097/TA.0b013e318232a6b3
Henry SM, Davis KA, Morrison JJ, Scalea TM. Can necrotizing soft tissue infection be reliably diagnosed in the emergency department? Trauma Surg Acute Care Open 2018;3:e00015. DOI: https://doi.org/10.1136/tsaco-2017-000157
Stevens DL, Bisno AL, Chambers HF, et al. Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the Infectious Diseases Society of America. Clin Infect Dis 2014;59:e10–e52. DOI: https://doi.org/10.1093/cid/ciu296
Leiblein M, Marzi I, Sander AL, et al. Necrotizing fasciitis: treatment concepts and clinical results. Eur J Trauma Emerg Surg 2018;44:279-90. DOI: https://doi.org/10.1007/s00068-017-0792-8
Stevens DL, Bryant AE. Necrotizing soft-tissue infections. N Engl J Med 2017;377:2253–65. DOI: https://doi.org/10.1056/NEJMra1600673

How to Cite

Poggiali, E., Santilli, G., & Vercelli, A. (2023). A rapidly progressive painful skin lesion. Emergency Care Journal, 19(1). https://doi.org/10.4081/ecj.2023.11046
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