EURORAD ESR

Case 12690

Acute idiopathic necrotizing fasciitis of the chest wall: a case report

Author(s)
Marziali S, Ciancarella P, Liberto V, Di Giuliano F, Di Caprera E. Simonetti G

Dipartimento Diagnostica per Immagini,
Imaging Molecolare,
Radioterapia e Radiologia Interventistica,
Policlinico Tor Vergata,
viale Oxford 81, 00133 Roma,
Università degli studi di Roma
 
Patient
male, 42 year(s)
 
 
  • Figure 1
    CT axial plane

    CT performed at 4:17 am: axial plane images (soft-tissue window) show gas collection in the right pectoralis major muscle, thickening of the fascial planes and increased reticular attenuation of subcutaneous fat tissue.

     
    Area of Interest: Musculoskeletal soft tissue; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Infection;
     
     
  • Figure 2
    CT sagittal plane

    CT performed at 4:17 am: sagittal plane images (lung window A-B; soft-tissue window C-D) show gas dissection of the right pectoralis major muscle. The examination excluded pneumonia.

     
    Area of Interest: Musculoskeletal soft tissue; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Infection;
     
     
  • Figure 3
    CT axial plane

    CT performed at 8:32 am): axial plane images (lung window) show the worsening of radiological features with increase of gas gangrene extended to almost all thoracic and shoulder girdles muscles.

     
    Area of Interest: Musculoskeletal soft tissue; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Infection;
     
     
  • Figure 4
    CT axial plane

    CT performed at 8:32 am: axial plane images (soft-tissue window). The right major pectoralis muscle is completely replaced by a gas collection. Note the endotracheal tube due to the respiratory failure and shock...

     
    Area of Interest: Musculoskeletal soft tissue; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Infection;
     
     
  • Figure 5
    CT sagittal plane

    CT performed at 8:32 am): sagittal plane images (lung window) show the extension to the shoulder girdle with the involvement of the infraspinatus and deltoid muscles.

     
    Area of Interest: Musculoskeletal soft tissue; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Infection;
     
     
CT performed at 4:17 am: axial plane images (soft-tissue window) show gas collection in the right pectoralis major muscle, thickening of the fascial planes and increased reticular attenuation of subcutaneous fat tissue.
 
CT performed at 4:17 am: sagittal plane images (lung window A-B; soft-tissue window C-D) show gas dissection of the right pectoralis major muscle. The examination excluded pneumonia.
 
CT performed at 8:32 am): axial plane images (lung window) show the worsening of radiological features with increase of gas gangrene extended to almost all thoracic and shoulder girdles muscles.
 
CT performed at 8:32 am: axial plane images (soft-tissue window). The right major pectoralis muscle is completely replaced by a gas collection. Note the endotracheal tube due to the respiratory failure and shock condition.
 
CT performed at 8:32 am): sagittal plane images (lung window) show the extension to the shoulder girdle with the involvement of the infraspinatus and deltoid muscles.
 
 
 
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