title: An atypical presentation of necrotising fasciitis.
abstract: Necrotising fasciitis is a rare infection with a high mortality rate. Clinical manifestation may be influenced by an underlying disease state. We report a case of a 70-year-old man with an anaplastic large-cell lymphoma who presented with inconclusive signs of necrotising fasciitis following a neutropenic phase after chemotherapy. Surgical exploration did not reveal the typical macroscopic features of necrotising fasciitis. Microbiological investigations revealed Escherichia coli. The lack of massive tissue inflammation, probably due to the neutropenia in our patient, has not been described by other authors. Diagnostic uncertainties owing to masked or uncharacteristic signs in immune compromised patients may lead to a delayed surgical debridement, of which clinicians should be aware.
authors.affiliation: Medical Intensive Care Unit, University Hospital Leipzig , Germany.
authors.forename: K
authors.initials: K
authors.lastname: Kunz
authors.affiliation: Medical Intensive Care Unit, University Hospital Leipzig , Germany.
authors.forename: F
authors.initials: F
authors.lastname: Seidel
authors.affiliation: Medical Intensive Care Unit, University Hospital Leipzig , Germany.
authors.forename: L
authors.initials: L
authors.lastname: Weidhase
authors.affiliation: Department of Orthopaedics, Trauma and Plastic Surgery, University Hospital Leipzig , Germany.
authors.forename: P
authors.initials: P
authors.lastname: Hepp
authors.affiliation: Department of Radiology, University Hospital Leipzig , Germany.
authors.forename: S
authors.initials: S
authors.lastname: Strocka
authors.affiliation: Institute of Pathology, University Hospital Leipzig , Germany.
authors.forename: T
authors.initials: T
authors.lastname: Gradistanac
authors.affiliation: Medical Intensive Care Unit, University Hospital Leipzig , Germany.
authors.forename: S
authors.initials: S
authors.lastname: Petros
mesh_terms: D000368:Aged; D004926:Escherichia coli; D004927:Escherichia coli Infections; D019115:Fasciitis, Necrotizing; D006801:Humans; D008223:Lymphoma / Q000150:complications*; D008297:Male; D009503:Neutropenia
keywords: E.Coli; Lymphoma; MTX; Necrotising Fasciitis; Neutropenia