Necrotizing fasciitis caused by the treatment of chronic non-specific back pain

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Abstract

Background

Chronic back pain is a multifactorial disease that occurs particularly in adults and has many negative effects on the quality of daily life. Therapeutic strategies are often multimodal and designed for a long-term therapy period. In some cases, one option is joint infiltration or intrathecal injection with local anaesthetics. An adverse effect of this intervention may be necrotic fasciitis, a disease with high mortality and few therapeutic options.

Case presentation

This case shows a 53-year-old female patient who developed necrotic fasciitis after infiltrations of the sacroiliac joint and after epidural-sacral and intrathecal injections.

Conclusion

Thanks to early and aggressive surgical intervention, antibiotic treatment and hyperbaric oxygenation, she survived this serious complication and was able to return to life.

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Most cited references 9

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Necrotizing fasciitis: treatment concepts and clinical results.

M Leiblein, I Marzi, A L Sander … (2017)

Necrotizing fasciitis is a life-threatening soft tissue infection characterized by a rapid spreading infection of the subcutaneous tissue and in particular the fascia. The management of infected tissues requires a rapid diagnosis, immediate aggressive surgical management and an extended debridement. In some cases early amputations of the affected tissues and maximum intensive care treatment, in case of sepsis, are required. Due to a rising number of cases we aimed to evaluate our patients in a retrospective review.

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Necrotizing fasciitis: pathogenesis and treatment.

N. Engleberg, David M Aronoff, Adam Young (2005)

Necrotizing fasciitis is a rapidly progressive, life-threatening infection and a true infectious disease emergency. Despite much clinical experience, the management of this disease remains suboptimal, with mortality rates remaining approximately 30%. Necrotizing fasciitis rarely presents with obvious signs and symptoms and delays in diagnosis enhance mortality. Therefore, successful patient care depends on the physician's acumen and index of suspicion. Prompt surgical debridement, intravenous antibiotics, fluid and electrolyte management, and analgesia are mainstays of therapy. Adjunctive clindamycin, hyperbaric oxygen therapy and intravenous immunoglobulin are frequently employed in the treatment of necrotizing fasciitis, but their efficacy has not been rigorously established. Improved understanding of the pathogenesis of necrotizing fasciitis has revealed new targets for rationally designed therapies to improve morbidity and mortality.

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Is Open Access

Chronic low back pain and postural rehabilitation exercise: a literature review

Teresa Paolucci, Carmine Attanasi, Walter Cecchini … (2018)

Chronic low back represents one of the major causes of disability worldwide. Our narrative review has the purpose of highlighting the evidence supporting the different rehabilitative techniques described for its management. In total, 26 studies were found suitable to be included in the review (14 articles about pilates, six about McKenzie (MK), one article about Feldenkrais, three about Global Postural Rehabilitation (GPR) and two about Proprioceptive Neuromuscular Facilitation). The effect of exercise therapy was examined for each single study through changes in the main clinical outcomes (pain, disability,) quality of life (QoL) and psychological aspects and the targeted aspects of physical function (muscle strength, mobility, muscular activity and flexibility). All the techniques are effective for the study groups with respect to the control groups in reducing pain and disability and improving the QoL and maintaining benefits at follow-up; pilates, Back School, MK and Feldenkrais methods reduce pain and are more efficient than a pharmacological or instrumental approach in reducing disability and improving all psychological aspects also. GPR shows long lasting results for the last outcome. To date, it is difficult to affirm the superiority of one approach over another. Further high quality research is needed to confirm the effect of these techniques, together with the use of more appropriate evaluation measures.

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Author and article information

Contributors

Lilit Floether:

ORCID: http://orcid.org/0000-0003-4825-327X

lilit.floether@uk-halle.de

Journal

Journal ID (nlm-ta): BMC Anesthesiol

Journal ID (iso-abbrev): BMC Anesthesiol

Title: BMC Anesthesiology

Publisher: BioMed Central (London )

ISSN (Electronic): 1471-2253

Publication date (Electronic): 26 September 2020

Publication date PMC-release: 26 September 2020

Publication date Collection: 2020

Volume: 20

Electronic Location Identifier: 245

Affiliations

[1 ]GRID grid.461820.9, ISNI 0000 0004 0390 1701, Department of Anesthesiology and Surgical Intensive Care, , University Hospital Halle (Saale), ; Ernst-Grube-Straße 40, 06120 Halle (Saale), Germany

[2 ]GRID grid.9018.0, ISNI 0000 0001 0679 2801, Department of Clinical Pharmacy and Pharmacotherapy, , Martin Luther University Halle-Wittenberg, ; Halle (Saale), Germany

Author information

Lilit Floether http://orcid.org/0000-0003-4825-327X

Article

Publisher ID: 1161

DOI: 10.1186/s12871-020-01161-0

PMC ID: 7519487

SO-VID: 7e86d119-7636-4bdc-8e78-ea0971937b04

License:

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