Case Report
Published: 01 September, 2025 | Volume 8 - Issue 2 | Pages: 015-017
Introduction: Necrotizing Fasciitis (NF) is a rapidly progressing and life-threatening soft tissue infection, exceedingly rare but often fatal in neonates. This case series highlights the rarity, fulminant nature, and poor prognosis of neonatal NF by presenting four cases.
Case presentation: Four neonates, aged 12-16 days, presented with rapidly spreading, tender, erythematous, and indurated skin lesions on their backs, initially resembling burns. Systemic symptoms like fever, lethargy, and poor feeding were common. Despite empirical antibiotics, the lesions progressed to necrosis, often with bullae formation. Microbiological cultures revealed polymicrobial growth in three cases (E. coli, Pseudomonas sp., Klebsiella, and MRSA) and monomicrobial growth of MRSA in one case, frequently exhibiting antibiotic resistance. Surgical debridement was performed in three cases. Despite aggressive management, two neonates succumbed to sepsis and multi-organ dysfunction. The other two neonates recovered after prolonged antibiotic therapy and wound care.
Discussion: These cases underscore the diagnostic challenges and rapid progression of NF in neonates. The consistent presentation after 10 days of birth, rapid lesion spread mimicking burns, and predilection for the back were notable features. Polymicrobial infection was frequent. Early recognition, aggressive broad-spectrum antibiotics, and timely surgical debridement are crucial for improving the poor prognosis associated with this condition.
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Neonate; Necrotising fasciitis; Sepsis
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