Fasciitis and septic shock complicating retrocecal appendicitis.
BACKGROUND
A case of fasciitis and septic shock complicating retrocecal appendicitis is presented.


METHODS
A 52-year-old man presented to the Emergency Department with lumbar pain, fever of recent onset and subsequently developed septic shock attributed to fasciitis of abdominal, flank and groin region. On intensive care unit, he was managed with broad-spectrum intravenous antibiotics and surgical debridement. An abdominal computed tomography scan confirmed the findings of fasciitis and was negative for intra-abdominal pathology. In the following days, an enterocutaneous fistula with foul smelling fluid was noted. A new surgical exploration revealed the presence of a ruptured retrocecal appendix, and right hemicolectomy was performed. The postoperative period was long but uneventful.


CONCLUSIONS
Retrocecal appendicitis can rarely be presented as deteriorating cellulitis-fasciitis in the right abdominal, flank or groin region, with or without abdominal symptoms.
Third Intensive Care Department Evgenidion Hospital, Athens, Greece. Electronic address: atsimog@med.uoa.gr.
Angeliki M
AM
Tsimogianni
Third Intensive Care Department Evgenidion Hospital, Athens, Greece.
Aikaterini
A
Flevari
Third Intensive Care Department Evgenidion Hospital, Athens, Greece.
Alex
A
Betrosian
Third Intensive Care Department Evgenidion Hospital, Athens, Greece.
Despoina
D
Sarridou
Third Intensive Care Department Evgenidion Hospital, Athens, Greece.
Ilias
I
Andrianakis
Third Intensive Care Department Evgenidion Hospital, Athens, Greece.
Emmanouil
E
Douzinas
Endoscopic Department, Evgenidion Hospital, Athens, Greece.
Dimitris
D
Bakos
D000890:Anti-Infective Agents / Q000627:therapeutic use*; D001064:Appendicitis / Q000150:complications / Q000175:diagnosis* / Q000382:microbiology / Q000601:surgery*; D001065:Appendix / Q000382:microbiology / Q000473:pathology* / Q000601:surgery; D003082:Colectomy; D003646:Debridement; D019115:Fasciitis, Necrotizing / Q000175:diagnosis* / Q000209:etiology; D006115:Greece; D006801:Humans; D007412:Intestinal Fistula / Q000150:complications / Q000175:diagnosis / Q000382:microbiology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D012422:Rupture, Spontaneous / Q000150:complications / Q000175:diagnosis / Q000382:microbiology / Q000601:surgery; D012772:Shock, Septic / Q000175:diagnosis* / Q000209:etiology; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D000890:Anti-Infective Agents