Challenges of Management: Necrotizing Fasciitis Complicating Acute Lymphoblastic Leukaemia in a Resource Limited Setting

Abstract

A 17 year male student presented with features of acute lymphoblastic leukaemia (L2 morphology) with severe thrombocytopenia, complicated by anaemic heart failure. He had limited resources being fatherless and had no access to the National Health Insurance Scheme (NHIS). While on admission he developed necrotizing fasciitis (NF) Type II. The cultured microorganism was Staphylococcus aureus. Treatment was irregular and his condition was complicated by Gram negative septicaemia. The patient could not afford treatment and died of shock. Necrotizing fasciitis is being reported here for the first time in a patient with leukaemia in Nigeria. The risk factors for NF, the challenges of managing a patient with limited resources and the need for a multidisciplinary care approach have been discussed.