title: [Fulminant isolated necrotizing fasciitis of the chest wall, complicating thoracic empyema].
abstract: Authors introduce the case of a 64-year-old male patient with fulminant isolated necrotizing fasciitis of the chest wall, complicating empyema thoracis of unknown origin. The patient's co-morbidities were hypertension, ischaemic heart disease, atrial fibrillation with oral anticoagulation. The real etiology was revealed post mortem, due to the rapid progression. The autopsy demonstrated that the fasciitis was caused by a small blunt thoracic trauma (haematoma), not emerged from patient's history and was not visible during physical examination. Authors review diagnostic pitfalls, leading to delayed recognition in addition to this very case. After quick diagnosis surgical debridement, targeted wide spectrum antibiotics and maximal intensive care are the basic pillars of the management of necrotizing fasciitis.
authors.affiliation: Sebészeti Osztály, Jász-Nagykun-Szolnok Megyei Hetényi Géza Kórház-Rendelőintézet 5000 Szolnok, Tószegi u. 21.
authors.forename: Ottó
authors.initials: O
authors.lastname: Kovács
authors.affiliation: Sebészeti Osztály, Jász-Nagykun-Szolnok Megyei Hetényi Géza Kórház-Rendelőintézet 5000 Szolnok, Tószegi u. 21.
authors.forename: Zoltán
authors.initials: Z
authors.lastname: Szántó
authors.affiliation: Patológiai Osztály, Jász-Nagykun-Szolnok Megyei Hetényi Géza Kórház-Rendelőintézet Szolnok.
authors.forename: Géza
authors.initials: G
authors.lastname: Krasznai
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D015897:Comorbidity; D003646:Debridement; D057210:Delayed Diagnosis; D018450:Disease Progression; D016724:Empyema, Pleural / Q000150:complications* / Q000175:diagnosis*; D019115:Fasciitis, Necrotizing / Q000150:complications* / Q000175:diagnosis / Q000601:surgery*; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012720:Severity of Illness Index; D035423:Thoracic Cavity; D035441:Thoracic Wall / Q000473:pathology / Q000601:surgery*
chemical_list: D000900:Anti-Bacterial Agents
keywords: blunt trauma; delayed diagnosis; elkésett diagnózis; fasciitis necrotizans of the chest wall; fulmináns lefolyás; mellkasfali fasciitis necrotisans; rapid progression; tompa trauma