Case Report Volume 6 Issue 4 - April 2018 DOI: 10.19080/JAICM.2018.06.555692 J Anest & Inten Care Med Copyright © All rights are reserved by Quratulain Masood Necrotizing Fasciitis: Race against Time to Salvage Limb from potential Amputations; a Case Report Quratulain Fatima Masood 1 *, Ali Asad 2 , Anika Naeem 2 , Saad Wasiq 2 , Sara Habib 3 , Maira Nusrat 2 , Fnu Sandeep 4 , Umair Hamid 2 , Vinesh Kumar 5 , Aimen Mubashar 6 , Atufa Kaleem 7 , Zainab Khan 8 , Umer Zia 2 , Hafiz Zarsham Ali Ikram 10 , Areej Khan 9 , Atif Ibrahi , Afshan Naz Amray 4 and Syed Yawar Mehdi 11 1 National University of Sciences and Technology, Pakistan 2 University of Health Sciences Lahore, Pakistan 3 Thomas Jefferson University, Pennsylvania 4 Dow University of Health Sciences, Pakistan 5 Ghulam Mohammad Maharashtra Medical College, Pakistan 6 Fatima Jinnah Medical College for Women Lahore, Pakistan 7 Hospital Multan, Pakistan 8 Nishter Medical University, Pakistan 9 King Edward Medical University, Pakistan 10 Khyber University, Pakistan 11 Aga Khan University Hospital, Pakistan Submission: April 10, 2018; Published: April 17, 2018 *Corresponding author: Quratulain Masood, National University of Sciences and Technology, Karachi, Pakistan, Email: J Anest & Inten Care Med 6(4): JAICM.MS.ID.555692 (2018) 001 Abstract Necrotizing Fasciitis is a rare, rapidly progressive and lethal infection of the soft tissues of the body, which can result in necrosis. Early diagnosis and prompt management with antibiotics and surgical debridement of the affected limb can prevent devastating outcomes. We present a case of a seven year old boy with altered mental status and cellulitis of his right thigh. Astute and rigorous care resulted in preventing limb amputation. Keywords: Necrotizing fasciitis; Prompt treatment Introduction “Flesh eating bacteria” or Necrotizing Fasciitis is a life threatening tissue infection that spreads swiftly. It often presents with local skin changes, fever and vomiting. Limbs and perineum are the most commonly involved infected sites. The major risk factors include a poor immune status, diabetes, cancer, obesity, alcoholism and peripheral arterial disease. Necrotizing Fasciitis is mostly a mono-microbial disease; Group A streptococcus and methicillin resistant staphylococcus aureus being the most common causative agents. The pathophysiology suggests the exotoxin production by bacteria causes necrosis of the tissue, activating immune responses and spreading extensively. There are various techniques of diagnosing it including the Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) scoring system. MRI has a better sensitivity and is the gold standard to diagnose it. Case Report A seven year old boy, was referred to our facility in an altered mental state with a swollen, erythematous right thigh, a rash of the overlying skin for the last three days. The patient was treated at a separate facility by orthopedic surgeon and neuro-physician. The patient was shifted to I.C.U and treated for septic shock. Empiric oral antibiotics and fluid resuscitation were started. Orthopedic consultation was sought, who advised immediate surgery. Intra operatively circumferential debridement of the necrotic skin, subcutaneous tissue and fascia were done. There was significant necrosis of the muscle of right thigh which also needed