A case of necrotizing fasciitis in a patient receiving chemotherapy for gastric cancer

Abstract

The patient was a 72-year-old man who had a total gastrectomy and splenectomy for gastric cancer 1 year earlier (T3, N2, H0, P0, CY1. M0, and stageIV). He received chemotherapy after surgery. He complained of left chest pain of one week's duration. The skin covering his left chest was edematous. Chest CT revealed thickening of the subcutaneous tissue of the left chest wall. A soft tissue infection of the left chest wall was suspected, and antibiotics were administered, but the infected area expanded rapidly ; bacterial cultures grew Streptococcus pyogenes.
Necrotizing fasciitis was suspected and antibiotics effective against Streptococcus pyogenes were given. Subsequently, the patient required emergent debridement and intensive care. After these treatments were given, he recovered and was discharged on the 68th hospital day.
Necrotizing fasciitis is a rapidly progressing infection with a high mortality. There are only a few case reports of necrotizing fasciitis in patients receiving chemotherapy. Nevertheless, necrotizing fasciitis should be considered as a possible complication of chemotherapy.