Bath salts and necrotizing fasciitis: a case report
January 26, 2012, 11:52 pm
Life-threatening Necrotizing Fasciitis Due to ‘Bath Salts’ Injection. Russo R et al. Orthopedics 2012 Jan 16;35(1):e124-7. doi: 10.3928/01477447-20111122-36.
This dramatic case report fro Louisiana State University Health Sciences Center describes a 34-year-old woman who developed a rapidly progressing necrotizing fasciitis several days after injecting a “bath salt” product intramuscularly into the right forearm.
The authors report that the infection was so virulent that: “In the time it took to expose the anterior upper arm, muscle in the forearm that had previously been contractile and pink had turned dusky and noncontractile.”
In the effort to debride necrotic tissue and establish clean margins, the surgeons performed a forequarter amputation, removing the right arm, clavicle, and scapula, as well as parts of the chest wall. A right radical mastectomy was also carried out.
The authors conclude that: “The key to treatment in this population [parenteral bath salt abusers] is early recognition and immediate extensive surgical debridement coupled with penicillin G and clindamycin IV antibiotics.”