DefinePK

Abstract

Abstract: 
Background Necrotizing fasciitis is a rare yet lethal skin infection that result in necrosis of subcutaneous tissue and fascia, with global incidence is recorded at 0.4/100,000 per year. Initial clinical presentation of NF resembles with that of cellulitis and erysipelas resulting in misdiagnosis and delay in effective treatment approach. NF usually progress to septic shock however in our case septic cerebral emboli was diagnosed following necrotizing fasciitis involving right breast, axilla and right upper arm. This is a rare presentation of septic cerebral emboli following NF, that is very rarely reported in literature.
Case presentation We are reporting exceptionally a unique case of 55 year old Pakistani woman presented in ER with fever, right breast wound extending to the right axilla and right upper arm in unconscious state with GCS of 6/15. Pathological examination of lesion revealed fibroadipose tissue with dense acute and chronic inflammation along with the creation of abscess and fat necrosis, hypo intense lesion on MRI T2 imaging and blooming on GRE indicated cerebral septic emboli. That was subsequently diagnosed with septic cerebral emboli following necrotizing fasciitis of breast. Patient was managed with antibiotics and multiple surgical debridement, however patient expired while being treated in the hospital.  
Discussion Necrotizing fasciitis often progress to septic shock but its progression to septic cerebral emboli remains uncommon, and it is very rarely discussed topic in medical literature. This article shadow light on rare and complex association of Septic cerebral emboli following necrotizing fasciitis.  Patient was managed with antibiotics and multiple surgical debridement, however patient expired during hospitalization.  
Keywords Necrotizing fasciitis, septic cerebral emboli.