Necrotizing Fasciitis: An Unusual Sequela Of Injections In Children
AbstractBackground: Necrotising fasciitis (NF) of the head and the trunk in children is a serious infection that carries high morbidity and mortality. We recently managed two infants with NF from injection mishap of the head and the trunk, respectively. The aim of this report is to highlight ways of effectively treating and/preventing cases of NF in children.
Patients and methods: Two children who presented with NF as sequela to injections to the head and the gluteus area were managed at the Jos University Teaching Hospital between July and November, 2002.
Radical ulcer debridement, adequate antibiotic cover and skin cover were the mainstay of the treatment.
Result: The infants were aged fourteen and eleven months, respectively, with ulcers measuring 18-21cm wide; average hospital stay was 10.9 weeks. Swab from the head lesion yielded a mixture of Streptococcus and Klebsiella spp, but none from the second ulcer. Polymicrobial therapy (cefuroxime and metronidazole) was effective. Split skin grafting yielded satisfactory outcome. Both patients survive.
Conclusion: NF is a dangerous infection of the skin and the subcutaneous tissue and very often runs a fatal course in children. Early recognition of NF may help to avert some of the mortal effects of this condition. Successful treatment of NF involves adequate resuscitation, administration of broad-spectrum antimicrobials, adequate debridement and skin cover. Prevention in the form of cautious use of injections to treat childhood illnesses cannot be over emphasised.
Key words: Necrotising fasciitis, injection, children.
Highland Medical Research Journal Vol.2(1) 2004: 61-63