Necrotizing Fasciitis: Following Uncontrolled Blood Glucose Level: A case report

Abstract

Necrotizing fasciitis is a rare bacterial infection that primarily involves the fascia and subcutaneous tissues. Diabetes mellitus, advanced age, and immune suppression are some of the predisposing causes of necrotizing fasciitis. A 56-year-old lady presented with fever, diarrhea, and left lower limb knee joint pain, swelling, and high random blood glucose level, which was 564mg/dl on admission. She was diagnosed with diabetes mellitus twenty-five years ago and regular treatments were taken for twenty years then defaulted for three years. Two years back again she started to take the treatments from a local hospital. Pain over the left knee joint gradually increased within two days and suddenly she got a septic shock while her blood investigations were showing changes of sepsis while blood pressure became lower. Knee joint exploration was done on the fifth day of hospital admission and altogether three wound toilets were completed within 10 days and treated with broad-spectrum antibiotics. Hence the patient clinically improved, and blood investigations became normal. Necrotizing fasciitis spreads rapidly in the body if not diagnosed and treated immediately. Early diagnosis is a golden fact for optimizing the disease condition as necrotizing fasciitis is a fatal disease condition. Strong antibiotics coverage, surgical interventions, proper wound care, and controlling blood glucose level lead to successful recovery from necrotizing fasciitis while reducing mortality and morbidity. In nursing management, nurses can collaborate with wound management, nutritional support, and psychosocial support, as well as encourage mobilizing and educating the patient regarding diabetes mellitus and its complications.