Necrotizing fasciitis secondary Crohn's disease

Necrotizing fasciitis is a life-threatening infection, commonly caused by g roup A streptococci, which has to be treated by surgical exploration and de bridement during the first 24 h. Clinical clues are severe pain, in some ca ses followed by the appearance of bullous formations, and the detection of gas in the soft tissues by computed tomography or MRI. fn addition to that, the infection is characterized by rapid inflammatory progression, producin g a highly life-threatening situation. Diagnosis is finally based on surgic al exploration obtaining specimens for culture and histopathologic examinat ion. Debridement and exploration, in some cases amputation of the extremity , are indicated as soon as possible. Antibiotic therapy increases efficacy too, but there is no substitute for surgical treatment. Inflammatory bowel disease (Crohn's disease in this case) followed by necrotizing fasciitis is rarely mentioned in the literature. Therapeutic management in a situation of immunosuppression is discussed by illustration of an actual case.