Skip to main content
Top
Published in: BMC Anesthesiology 1/2020

Open Access 01-12-2020 | Necrotizing Fasciitis | Case report

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

Authors: Lilit Floether, Michael Bucher, Ralf Benndorf, Anna-Maria Burgdorff

Published in: BMC Anesthesiology | Issue 1/2020

Login to get access

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.
Literature
1.
go back to reference Mathieson S, Kasch R, Maher CG, Pinto RZ, McLachlan AJ, Koes BW, et al. Combination drug therapy for the Management of low Back Pain and Sciatica: systematic review and meta-analysis. J Pain. 2019;20:1–15.CrossRef Mathieson S, Kasch R, Maher CG, Pinto RZ, McLachlan AJ, Koes BW, et al. Combination drug therapy for the Management of low Back Pain and Sciatica: systematic review and meta-analysis. J Pain. 2019;20:1–15.CrossRef
2.
go back to reference Paolucci T, Attanasi C, Cecchini W, Marazzi A, Capobianco SV, Santilli V. Chronic low back pain and postural rehabilitation exercise: a literature review. J Pain Res. 2019;12:95–107.CrossRef Paolucci T, Attanasi C, Cecchini W, Marazzi A, Capobianco SV, Santilli V. Chronic low back pain and postural rehabilitation exercise: a literature review. J Pain Res. 2019;12:95–107.CrossRef
3.
go back to reference Bundesärztekammer, Kassenärztliche Bundesvereinigung, Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften: Nationale VersorgungsLeitlinie Nicht-spezifischer Kreuzschmerz – Langfassung. 2. Auflage. Version 1. Belin; 2017. Bundesärztekammer, Kassenärztliche Bundesvereinigung, Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften: Nationale VersorgungsLeitlinie Nicht-spezifischer Kreuzschmerz – Langfassung. 2. Auflage. Version 1. Belin; 2017.
4.
go back to reference Airaksinen O, Brox JI, Cedraschi C, Hildebrandt J, Klaber-Moffett J, Kovacs F, et al. Chapter 4. European guidelines for the management of chronic nonspecific low back pain. Eur Spine J. 2006;15(Suppl 2):S192–300.CrossRef Airaksinen O, Brox JI, Cedraschi C, Hildebrandt J, Klaber-Moffett J, Kovacs F, et al. Chapter 4. European guidelines for the management of chronic nonspecific low back pain. Eur Spine J. 2006;15(Suppl 2):S192–300.CrossRef
5.
go back to reference Friederichs J, Torka S, Militz M, Bühren V, Hungerer S. Necrotizing soft tissue infections after injection therapy: higher mortality and worse outcome compared to other entry mechanisms. J Inf Secur. 2015;71:312–6. Friederichs J, Torka S, Militz M, Bühren V, Hungerer S. Necrotizing soft tissue infections after injection therapy: higher mortality and worse outcome compared to other entry mechanisms. J Inf Secur. 2015;71:312–6.
6.
go back to reference Young MH, Engleberg NC, Mulla ZD, Aronoff DM. Therapies for necrotising fasciitis. Expert Opin Biol Ther. 2006;6:155–65.CrossRef Young MH, Engleberg NC, Mulla ZD, Aronoff DM. Therapies for necrotising fasciitis. Expert Opin Biol Ther. 2006;6:155–65.CrossRef
7.
go back to reference Escobar SJ, Slade JB Jr, Hunt TK, Cianci P. Adjuvant hyperbaric oxygen therapy (HBO2) for treatment of necrotizing fasciitis reduces mortality and amputation rate. Undersea Hyperb Med. 2005;32:437–43.PubMed Escobar SJ, Slade JB Jr, Hunt TK, Cianci P. Adjuvant hyperbaric oxygen therapy (HBO2) for treatment of necrotizing fasciitis reduces mortality and amputation rate. Undersea Hyperb Med. 2005;32:437–43.PubMed
8.
go back to reference Bredow J, Bloess K, Oppermann J, Boese CK, Löhrer L, Eysel P. Konservative Therapie beim unspezifischen, chronischen Kreuzschmerz: Evidenz der Wirksamkeit - eine systematische Literaturanalyse. Orthopade. 2016;45:573–8.CrossRef Bredow J, Bloess K, Oppermann J, Boese CK, Löhrer L, Eysel P. Konservative Therapie beim unspezifischen, chronischen Kreuzschmerz: Evidenz der Wirksamkeit - eine systematische Literaturanalyse. Orthopade. 2016;45:573–8.CrossRef
9.
go back to reference Kanai A, Okamoto T, Hayashi N, Shimao J, Nagahara Y, Fujii K. Short-term results of intrathecal injection of low-dose bupivacaine in outpatients with chronic low back and lower extremity pain. Eur Spine J. 2019;28:250–8.CrossRef Kanai A, Okamoto T, Hayashi N, Shimao J, Nagahara Y, Fujii K. Short-term results of intrathecal injection of low-dose bupivacaine in outpatients with chronic low back and lower extremity pain. Eur Spine J. 2019;28:250–8.CrossRef
10.
go back to reference Young MH, Aronoff DM, Engleberg NC. Necrotizing fasciitis: pathogenesis and treatment. Expert Rev Anti-Infect Ther. 2005;3:279–94.CrossRef Young MH, Aronoff DM, Engleberg NC. Necrotizing fasciitis: pathogenesis and treatment. Expert Rev Anti-Infect Ther. 2005;3:279–94.CrossRef
11.
go back to reference Leiblein M, Marzi I, Sander AL, Barker JH, Ebert F, Frank J. Necrotizing fasciitis: treatment concepts and clinical results. Eur J Trauma Emerg Surg. 2018;44:279–90.CrossRef Leiblein M, Marzi I, Sander AL, Barker JH, Ebert F, Frank J. Necrotizing fasciitis: treatment concepts and clinical results. Eur J Trauma Emerg Surg. 2018;44:279–90.CrossRef
Metadata
Title
Necrotizing fasciitis caused by the treatment of chronic non-specific back pain
Authors
Lilit Floether
Michael Bucher
Ralf Benndorf
Anna-Maria Burgdorff
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Anesthesiology / Issue 1/2020
Electronic ISSN: 1471-2253
DOI
https://doi.org/10.1186/s12871-020-01161-0

Other articles of this Issue 1/2020

BMC Anesthesiology 1/2020 Go to the issue