[Necrotizing fasciitis of the perineum secondary to a surgical treatment of Bartholin's gland abscess].
Necrotizing fasciitis of the perineum is a rare but of fast evolution, and potentially fatal infectious disease process. It is characterized by progressive inflammation and extensive necrosis of subcutaneous tissue involving the fascia and other adjacent tissues. This infection may be idiopathic or secondary to local trauma or pelvic surgery. Its mortality rate is 20%. We report a case of necrotzing fasciitis of the perineum in a 34-year-old woman following incision and drainage of Bartholin's gland abscess. Streptococcus A, Proteus mirabilis, Escherichia coli, and Candida albicans were isolated. Intravenous broad spectrum antibiotic therapy was promptly instituted. Concurrent surgical debridement of all necrotic areas was required. Post debridement therapy required a long period of dressing changes until cicatrisation. Necrotizing fasciitis of the perineum is a surgical emergency. Early diagnosis and prompt aggressive debridement are the keys to successful management.
Kdous
M
M
Service de gynécologie-obstétrique, hôpital Lariboisière, 2, rue Ambroise-Paré, 75010 Paris, France. kdousm@excite.com
Hachicha
R
R
Iraqui
Y
Y
Jacob
D
D
Piquet
P-M
PM
Truc
J-B
JB
D000038:Abscess / Q000382:microbiology / Q000601:surgery*; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001472:Bartholin's Glands; D002176:Candida albicans / Q000302:isolation & purification; D004322:Drainage / Q000009:adverse effects; D004926:Escherichia coli / Q000302:isolation & purification; D019115:Fasciitis, Necrotizing / Q000188:drug therapy / Q000209:etiology* / Q000601:surgery; D005260:Female; D006801:Humans; D010502:Perineum; D011183:Postoperative Complications; D011513:Proteus mirabilis / Q000302:isolation & purification; D013291:Streptococcus / Q000302:isolation & purification; D014845:Vulvar Diseases / Q000382:microbiology / Q000601:surgery*
D000900:Anti-Bacterial Agents