Successful management of a 24-year-old pregnant woman with necrotising fasciitis of the forearm

Sam Nahas*, Anne Mckirdy, Arjuna Imbuldeniya

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)


A 24-year-old woman who was 24 weeks pregnant presented to the emergency department with septic shock and an elbow wound that had become infected. She sustained an injury to the tip of the right elbow on a light switch 4 days prior. In the space of 1 day, she developed a necrotising soft tissue infection, which was rapidly spread to the forearm with florid sepsis. Her initial serum C reactive protein was 392 mg/L, and white cell count was 32×10 9/L. The patient was treated promptly with aggressive surgical debridement and broad-spectrum antibiotics. An early multidisciplinary approach including orthopaedic surgeons, anaesthetics, intensive care, obstetrics, microbiologists and paediatrics was taken. Ultimately, both mother and child had an excellent outcome, the former of whom only had minimal soft tissue resection and primary wound closure. Emphasis is made on first treating the mother as the patient and priority.

Original languageEnglish
Article numberbcr-2017-222191
JournalBMJ Case Reports
Publication statusPublished - 2018
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2018 BMJ publishing Group Ltd. All Rights Reserved.


  • obstetrics and gynaecology
  • orthopaedics
  • plastic and reconstructive surgery


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