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American Journal of Critical Care. 2009;18: 288-287 doi:10.4037/ajcc2009363
Copyright © 2009 by the American Association of Critical-Care Nurses.
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Cases of Note features peer-reviewed case reports and case series that document clinically relevant findings from critical and high acuity care environments. Cases that illuminate a clinical diagnosis or a management issue in the treatment of critically and acutely ill patients and include discussion of the patient’s experience with the illness or intervention are encouraged. Proposals for future Cases of Note articles may be e-mailed to ajcc{at}aacn.org.

Necrotizing Fasciitis in a Plaster-Casted Limb: Case Report

By Giora Netzer, MD, MSCE and Barry D. Fuchs, MD. Giora Netzer is an assistant professor in the Division of Pulmonary and Critical Care Medicine, and the Department of Epidemiology and Preventive Medicine at the University of Maryland. Barry D. Fuchs is an associate professor in the Division of Pulmonary and Critical Care Medicine, University of Pennsylvania School of Medicine, and director of the medical intensive care unit at the University of Pennsylvania Hospital.

Corresponding author: Giora Netzer, MD, MSCE, Assistant Professor of Medicine, Director of Clinical Research, Division of Pulmonary and Critical Care Medicine, University of Maryland School of Medicine, 685 W Baltimore St, MSTF 800, Baltimore, MD 21201 (e-mail: gnetzer{at}medicine.umaryland.edu).

Casts may be associated with, and mask, serious life-threatening complications, including infection, compartment syndrome, and deep vein thrombosis with or without pulmonary embolism. A 43-year-old woman had necrotizing fasciitis associated with a closed-reduction casting of a tibial fracture. Her treatment highlights the importance of removing a cast and assessing the skin and tissue underneath for signs of infection in patients with suspected infection. Thorough assessment, early diagnosis, and early intervention in necrotizing fasciitis and sepsis are important to improve patients’ outcomes.






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Copyright © 2009 by the American Association of Critical-Care Nurses.