Necrotizing Fasciitis Causing Acute Compartment Syndrome after Radial Artery Catheterization

Authors

• Filipa Cabral Amado Serviço de Medicina 1, Centro Hospitalar de Leiria, Leiria Portugal
• Carlos Noversa Serviço de Anestesiologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
• Andreia Moura Serviço de Anestesiologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
• Luís Carvalho Serviço de Medicina 1, Centro Hospitalar de Leiria, Leiria Portugal
• Leila Cardoso

filipa.cabralamado@hotmail.com

Keywords

Abstract

Necrotizing fasciitis is a rare but potentially fatal infection involving the subcutaneous tissue and fascia with the development of necrosis of these structures. Acute compartment syndrome occurs when increased pressure within a closed muscle compartment compromises the circulation and function of the tissues within that space. We report the case of a male patient who was admitted to the intensive care unit for the management of urosepsis due to an acute obstructive pyelonephritis complicated by cardiopulmonary arrest. A radial arterial catheter in the left arm was urgently inserted, under suboptimal aseptic technique. His clinical condition progressively deteriorated, and swelling of the left arm with extension to the forearm with incipient signs of compromised perfusion were observed. The diagnosis of necrotizing fasciitis with acute compartment syndrome was made and an emergency fasciectomy performed. Following this, the patient gradually improved, organ dysfunction resolved, and he was discharged without sequelae.