Abstract
The aim of this presentation is to report a case of the treatment of extensive deep necrosis on upper and lower extremities in a 1 year old girl hospitalized with meningococcal sepsis, causing multiple organ failure treated with long-term artificial pulmonary ventilation, antibiotics and intensive local care of damaged tissue. In a previously healthy 1 year old girl, septic shock and multiple organ failure developed as a result of meningococcal septicaemia.
In the first 24 hours, extensive deep necrosis appeared on distal parts of all extremities. The first recommendation from plastic surgeons was amputation.
We have started with enzymatic necrectomy with alginogels. The right side healed spontaneously.
Some necrotic parts on left side were separated spontaneously with consequent surgical reconstruction; overall the extremities healed with satisfactory result. The patient is able to walk/run without problems, assuming she wears orthopaedic shoes.
The meningococcal sepsis is very insidious illness with high mortality and morbidity. One of its possible consequences in surviving patients is necrosis.
The use of enzymatic necrectomy (alginogels) had minimalized the loss of tissue in our patient even with the unfavourable initial condition. The vaccination is a significant way of prevention of this illness in the most vulnerable groups of the patients.