International Session 1 Surgical Management of Severe Anorectal and Pelvic Infections

[INTS1-2] Successful Management of Extensive Perianal Necrotizing Fasciitis with Mediastinal Involvement Using Single Radical Debridement: A Case Report

*Haoyan Li¹, Chaoyun Chen¹, Shiwei Chen¹, Yang Li¹ (1. Colorectal Surgery, The Affiliated TCM Hospital of Guangzhou Medical University, China)

Necrotizing fasciitis (NF) is a rare but rapidly progressing soft-tissue infection with high mortality if not promptly treated. We present a 34-year-old man who developed severe NF following radical drainage of a perianal abscess combined with hemorrhoid ligation. The infection extended from the perineum to the abdominal wall, gluteal region, and mediastinum. Cultures confirmed a type I polymicrobial infection with Escherichia coli, Enterococcus raffinosus, and Candida albicans. Urgent radical debridement, broad-spectrum antimicrobial therapy, intensive organ support, and nutritional care resulted in full recovery without repeat surgery. This case emphasizes the importance of early diagnosis, decisive surgical intervention, and multidisciplinary management in extensive NF.