Necrotizing fasciitis following rapidly deteriorating neonatal omphalitis with good initial presentation

• DOI: 10.1016/j.idcr.2023.e01750
• Publication Date: 2023-03-29T16:34:14Z
• Authors: Jin Sato; Nobuyuki Yotani; Kensuke Shoji; Teizaburo Mori; Akihiro Fujino; Makoto Hikosaka; Mitsuru Kubota; Akira Ishiguro
• Keywords: Debridement (dental)

Neonatal omphalitis is a postpartum infection of periumbilical superficial soft tissues that usually has good prognosis in developed countries. In rare cases, it could progress to necrotizing fasciitis (NF), which an the deep tissues, including muscle fascia, and high mortality rate. However, signs timing developing NF secondary are unclear. We encountered neonatal case following omphalitis. initial days clinical course, general symptoms condition patient were good, abdominal physical findings mild; however, rapidly NF. The was successfully treated by emergent surgical debridement, broad-spectrum antibiotics, intensive care. To determine area blood perfusion, we intravenously injected indocyanine green intraoperative angiography, then extensively removed necrotic hypoperfused tissues. omphalitis, deterioration can suddenly occur despite conditions; monitoring should be required during first few course.