8 / 238
8
29
th
CONGRESS OF THE ESPU
MWC: Special Session
"MY WORST COMPLICATION"
Moderator: Emilio Merlini (Italy)
ESPU Meeting on Friday 13, April 2018, 10:50–11:30
10:50–10:55
MWC-1 (LO)
NECROTIZING FASCIITIS IN A CHILD: A CASE REPORT
AFTER ORCHIDOPEXY
Anne Carolien BOUMA-HOUWERT, Panagiotis MITSOS and Aart J. KLIJN
WKZ Utrecht, Urology, Utrecht, NETHERLANDS
PURPOSE
Necrotizing fasciitis (NF) is a rare fulminant and rapidly spreading infection with a high mortality rate
of 15,4 %.
MATERIAL AND METHODS
We report the case of a 2-year old boy with NF after orchidopexy and a literature review.
RESULTS
A 2 year old boy underwent bilateral orchidopexy. One day later he presented with scrotal pain
and vomiting. He had no fever, was tachycardic, had no tender abdomen and an edematous
painfull scrotum. Blood laboratory showed a slightly increased serum C- reactive protein (45 mg/L).
Ultrasound revealed a hematoma of the scrotum. Six hours later he became febrile, had systemic
signs of sepsis and edematous changes of the skin without colouring. He was admitted on intrave-
nous antibiotics. Twelve ours after admission, progression of edema and colouring of the skin was
observed. The child was urgently operated for exploration. Surgical debridement involved the lower
abdominal wall, scrotum and the upper limbs. Intraoperative resection revealed severely inflamed,
necrotic, nonviable tissue. Wound cultures revealed a Streptococcus pyogenes and histopathology
confirmed the diagnosis NF. A second debridement was performed eight hours later and final wound
closure started after seven days. He was discharged 33 days after admission.
A Pubmed literature search was conducted from 1993 till now: no cases of NF after orchidopexy
were found.
CONCLUSIONS
We report the case of a 2-year old boy with NF after orchidopexy and his treatment which to the
authors’ knowledge has not been previously described.