A Rare Case of Ischial Tubercle Pressure Sore with Secondary Periperineal Necrotizing Fasciitis.

Background: Perineal necrotizing fasciitis, or Fournier's gangrene, is a rare but rapidly progressing condition characterized by fascial necrosis. It is a severe, potentially life-threatening infection requiring prompt diagnosis and standardized treatment to optimize patient outcomes.

Case presentation: A 48-year-old woman with poorly controlled type 2 diabetes developed necrotizing fasciitis of the right perineum secondary to an ischial tuberosity pressure ulcer. She had a prior spinal cord injury resulting in sensory dysfunction in the lower limbs, which masked significant pain. Management included surgical debridement, open wound care, antimicrobial therapy, and a free skin graft for wound closure.

Conclusion: Effective treatment of necrotizing fasciitis relies on aggressive debridement and appropriate antimicrobial therapy. This case highlights the importance of early recognition and intervention to improve clinical diagnostic and management strategies.