TY - JOUR AB - Necrotizing fasciitis of the chest wall is a very rare pathology, but with significant mortality, representing a therapeutic challenge. All international reports indicate the need for early diagnosis and an aggressive medical‑surgical attitude in order to improve the prognosis. In addition to a review of literature, we present a case developed secondary to a thoracic pleural drainage for pyopneumothorax associated with significant bronchopleural fistula in a destroyed tuberculous left lung. Along with medical treatment, extensive surgical debridement was required. Despite drainage incisions and negative pressure wound therapy (NPWT), the evolution of the fasciitis was difficult, due to bronchopleurocutaneous fistula. Thus, the Azorin procedure (transcervical mediastinoscopic closure of the left main bronchus) was performed. Once this procedure was completed, the inflammatory phenomena were controlled which allowed for a second step consisting of left pneumonectomy, with the application of specific methods for the prevention of bronchial fistula. The clinical case was a therapeutic challenge requiring a complex, staged, multidisciplinary approach due to both the immunocompromised terrain and the severity of the lesions. In conclusion, early recognition and aggressive and combined application of medical and surgical treatment methods can ensure therapeutic success. AD - Department of Thoracic Surgery, ‘Marius Nasta’ National Institute of Pneumology, 050152 Bucharest, Romania Department of Urology, ‘Prof. Dr. Th. Burghele’ Clinical Hospital, 061344 Bucharest, Romania Department of General Surgery, ‘Sf. Ioan’ Clinical Emergency Hospital, 042122 Bucharest, Romania Department of Pneumology, ‘Marius Nasta’ National Institute of Pneumology, 050152 Bucharest, Romania AU - Petreanu,Cornel,Adrian AU - Constantin,Traian AU - Iosifescu,Razvan AU - Gibu,Alexandru AU - Zariosu,Alexandru AU - Croitoru,Alina DA - 2022/01/01 DO - 10.3892/etm.2021.11013 IS - 1 JO - Exp Ther Med KW - necrotizing fasciitis chest wall infection bronchopleural fistula transcervical mediastinoscopic bronchial closure tuberculous destroyed lung PY - 2022 SN - 1792-0981 1792-1015 SP - 90 ST - Necrotizing fasciitis of the chest wall: A clinical case report and literature review T2 - Experimental and Therapeutic Medicine TI - Necrotizing fasciitis of the chest wall: A clinical case report and literature review UR - https://doi.org/10.3892/etm.2021.11013 VL - 23 ER -