• Ilaria Tocco, Luca Lancerotto, Alex Pontini, Anna Voltan, and Bruno Azzena.
• Institute of Plastic Surgery, University Hospital of Padova, Padova, Italy.
• J Emerg Med. 2013 Dec 1;45(6):e187-91.

BackgroundNecrotizing fasciitis (NF) is an infection of the soft tissue, and is fatal if not promptly and aggressively treated. Although it is rare, it is not exceptional; nevertheless, its presentation may be misleading and may delay the diagnosis. We highlight the possible synchronous development of NF in multiple noncontiguous areas.Case ReportA 44-year-old diabetic man with no history of trauma complained of nonspecific lower back pain, which he treated with analgesics and oral antibiotics. Erythema at the left arm appeared, and the general condition worsened. The patient was admitted to the Emergency Department, and NF was diagnosed at the right gluteus and left arm.Conclusion"Synchronous" multifocality is not an expected presentation of NF, and it complicates the diagnosis and delays treatment, with a potentially negative impact on outcome.Copyright © 2013 Elsevier Inc. All rights reserved.

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