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Clinics and Practice
Volume 10
Issue 1
10.4081/cp.2020.1218
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Clinics and Practice is published by MDPI from Volume 11 Issue 1 (2021). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by MDPI on mdpi.com as a courtesy and upon agreement with PAGEPress.
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Case Report

Necrotizing Fasciitis of the Upper Back Presenting with Left Shoulder Pain

by
Mohamad Zikri Mohamad Isa
1,
Mohamed-Syarif Mohamed-Yassin
1,* and
Roqiah Fatmawati Abdul Kadir
2
1
Department of Primary Care Medicine, Faculty of Medicine, Universiti Teknologi MARA, Selayang Campus, Selangor, Malaysia
2
Department of Radiology, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh Campus, Selangor, Malaysia
*
Author to whom correspondence should be addressed.
Clin. Pract. 2020, 10(1), 1218; https://doi.org/10.4081/cp.2020.1218
Submission received: 28 October 2019 / Revised: 21 March 2020 / Accepted: 10 April 2020 / Published: 27 April 2020

Abstract

Necrotizing fasciitis is a severe and progressive infection of deep soft tissues which results in destruction of the fascia and overlying subcutaneous fat. We report a case of a 45-year-old diabetic gentleman who initially presented with left shoulder pain, which was treated symptomatically. Upon representation, he had fever and the pain extended to his left upper back. There was a warm, firm and mildly tender purplish swelling on his mid to the left upper back. Blood tests revealed significantly elevated white cell counts and C-reactive protein. A CT thorax showed extensive soft tissue gas within the deep and superficial fascial layers of his left upper back. Necrotizing fasciitis was confirmed intraoperatively. The diagnosis of this condition is often difficult as early symptoms can be mild and nonspecific. A high Laboratory Risk Indicator for NECrotizing fasciitis (LRINEC) score may be helpful to rule in this diagnosis and guide further management.
Keywords: necrotizing fasciitis; shoulder pain; LRINEC score; diabetes mellitus necrotizing fasciitis; shoulder pain; LRINEC score; diabetes mellitus

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MDPI and ACS Style

Mohamad Isa, M.Z.; Mohamed-Yassin, M.-S.; Abdul Kadir, R.F. Necrotizing Fasciitis of the Upper Back Presenting with Left Shoulder Pain. Clin. Pract. 2020, 10, 1218. https://doi.org/10.4081/cp.2020.1218

AMA Style

Mohamad Isa MZ, Mohamed-Yassin M-S, Abdul Kadir RF. Necrotizing Fasciitis of the Upper Back Presenting with Left Shoulder Pain. Clinics and Practice. 2020; 10(1):1218. https://doi.org/10.4081/cp.2020.1218

Chicago/Turabian Style

Mohamad Isa, Mohamad Zikri, Mohamed-Syarif Mohamed-Yassin, and Roqiah Fatmawati Abdul Kadir. 2020. "Necrotizing Fasciitis of the Upper Back Presenting with Left Shoulder Pain" Clinics and Practice 10, no. 1: 1218. https://doi.org/10.4081/cp.2020.1218

APA Style

Mohamad Isa, M. Z., Mohamed-Yassin, M. -S., & Abdul Kadir, R. F. (2020). Necrotizing Fasciitis of the Upper Back Presenting with Left Shoulder Pain. Clinics and Practice, 10(1), 1218. https://doi.org/10.4081/cp.2020.1218

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