Aggressive management of necrotizing fasciitis in cancer patients: a case report

BACKGROUND: Necrotizing fasciitis is a rare infection in pediatrics with high mortality, it accounts for 0.03% of the causes of hospitalization in children, the cornerstone of treatment is surgical, through debridement as well as the early administration of antibiotics. CLINICAL CASE: 5-year-old female, with a one-month history characterized by fever, adenopathy, asthenia, adynamia and petechiae; Presents hematic biometry with pancytopenia, for which a bone marrow aspiration is performed with a diagnosis of acute lymphoblastic leukemia, a steroid window begins, presenting on the seventh day a rapidly progressive lesion in the right leg, evolving with blisters and necrosis which compromises skin, subcutaneous cellular tissue and gastrocnemius muscle; For this reason, aggressive surgical management was decided; she is currently in the remission induction phase with a remitted right leg injury. CONCLUSIONS: Necrotizing fasciitis is a medical and surgical emergency, in patients with oncological pathology it presents a rapid progression given their acquired immunosuppression, aggressive surgical treatment must be established before 24 hours of initiation to improve the prognosis and reduce mortality.