Necrotising fasciitis in the COVID-19 era: A consequence of caution – A case series. (June 2022)

• Record Type: Journal Article
• Authors: Feeney, Gerard; Hannan, Enda; Fallon, John; Curran, Eimear; Meagher, Helen; Sheehan, Jean; Coffey, John Calvin; Kavanagh, Eamon G.
• Is Part Of: International journal of surgery open. Volume 43(2022)
• Publication Date: 2022-06
• Subjects: Necrotising fasciitis -- Fournier's gangrene -- COVID-19 -- Coronavirus -- Pandemic; NF Necrotising fasciitis -- COVID-19 Coronavirus disease 19 -- AKI Acute kidney injury -- OT Operating theatre -- ICU Intensive care unit -- AKA Above knee amputation; Surgery -- Periodicals; 617.005
• DOI: 10.1016/j.ijso.2022.100488
• Languages: English
• ISSNs: 2405-8572

Abstract

Abstract: Necrotising fasciitis (NF) is a severe soft tissue infection that is associated with a high risk of morbidity and mortality. During the coronavirus disease 19 (COVID-19) pandemic, the population has been actively discouraged from presenting to emergency medical services unless absolutely necessary. While this was an important step in allowing for preservation of limited resources in a time of crisis, it may have resulted in immeasurable 'secondary victims' of the pandemic as patients with time-critical conditions delay hospital presentation. In this case series, we describe three patients that noted symptoms of soft tissue infection, but delayed seeking healthcare advice due to concerns regarding COVID-19 exposure. All three progressed to NF, requiring highly morbid wide surgical debridement and prolonged hospital admission, with a high risk of potential mortality. The findings of this series demonstrate the importance of consistently delivering appropriate and timely healthcare interventions to patients with non-COVID-19-related conditions. While efforts must be made to ensure preservation of valuable healthcare resources in a global pandemic, patients must also be empowered to seek timely care for non-COVID-19-related conditions even in this time of crisis. Highlights: NF is a severe soft tissue infection that requires urgent surgical intervention. The public has been advised to avoid hospitals during the COVID-19 pandemic. We observed a sharp increase in presentations with NF during national lockdown. All patients admitted to delaying presentation earlier with milder symptoms. It is essential that patients seek timely care for non-COVID-19 related conditions.