Spontaneous Necrotizing Fasciitis: Occurrence Secondary to Occult Diverticulitis

• Published in: JAMA : the journal of the American Medical Association Vol. 238; no. 21; p. 2302
• Main Authors: Galbut, David L, Gerber, Diane L, Belgraier, Arnold H
• Format: Journal Article
• Language: English
• Published: United States American Medical Association 21-11-1977
• Subjects: Aged; Colostomy; Diverticulitis - complications; Diverticulitis - surgery; Fascia; Female; Humans; Inflammation - etiology; Necrosis
• ISSN: 0098-7484; 1538-3598
• DOI: 10.1001/jama.1977.03280220070029

NECROTIZING fasciitis is an uncommon but severe clinical infection. It was reported in the literature more than 100 years ago as "hospital gangrene."1Necrotizing fasciitis is the preferred nomenclature because the essential characteristic is superficial or deep fascial necrosis, with extensive undermining of surrounding tissue.2,3Necrotizing fasciitis is most frequently found in lower extremities. It is also found in the upper extremities and in the abdomen.2,3 Necrotizing fasciitis of the extremity is usually caused by external injury, which may be so minor as to go unnoticed by the person. Abdominal-wall necrotizing fasciitis is generally a postoperative complication.2,3 Occult diverticulitis has been found, in rare instances, with lower-extremity necrotizing fasciitis.4 To our knowledge, spontaneous abdominal-wall necrotizing fasciitis secondary to occult diverticulitis has not been reported in the English literature.Report of a CaseA 71-year-old woman was admitted to Columbia-Presbyterian Medical Center in August 1976 with