Necrotizing fasciitis as an initial manifestation of perforated rectal cancer in a young man

AbstractNecrotizing fasciitis, commonly known as flesh-eating disease or flesh-eating bacteria syndrome, is a rare infection that affects and easily spreads across the deep fascia of the skin and subcutaneous tissues. Literature reviews have identified several related risk factors and these include malignancy, alcoholism, malnutrition, diabetes, male gender, and old age. There are few case reports in the literature describing this rare disease in association with colorectal malignancy. Perforated colorectal carcinoma often presents as an acute abdomen infection in most cases. Here we report a young man with a unique case of perforated rectal cancer that was disclosed by necrotizing fasciitis of the right lower limb without any sign or symptom of peritonitis. This case highlights the need for prompt diagnosis, urgent aggressive surgical debridement and consideration of a rare underlying cause when managing necrotizing fasciitis