Síndrome de distrés respiratorio agudo y fascitis necrotizante fulminante tras infiltración glútea de biopolímeros: reporte de un caso con desenlace fatal

Abstract

Systemic reactions induced by biopolymers represent a growing challenge in intensive care medicine due to their ability to trigger uncontrolled inflammatory responses and multiorgan damage. We report the case of a 30-year-old woman who, following gluteal infiltration with biopolymers, developed a rapidly progressive clinical picture characterised by severe acute respiratory distress syndrome (ARDS), septic shock, and bilateral necrotising fasciitis. During her stay in the intensive care unit, the patient presented with refractory hypoxaemia, mixed acidosis, right ventricular dysfunction, acute kidney injury, and hepatocellular necrosis, despite advanced management with protective mechanical ventilation, combined vasopressor support, corticosteroids, and passive immunotherapy. Imaging studies revealed diffuse alveolar damage with a ground-glass pattern, while local findings confirmed rapidly progressing necrosis of the skin and subcutaneous tissue. The fatal outcome reflected the aggressiveness of the systemic inflammatory process induced by these substances. This case highlights the importance of early recognition, multidisciplinary response, and timely critical decision-making within the intensive care environment. It also underscores the need to strengthen preventive strategies and public health education regarding the use of unauthorised aesthetic materials.