A Case of Necrotizing Fasciitis in Which Interleukin‐6 Measurement Helped in the Decision for Large‐Scale Amputation of the Left Shoulder and Arm

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Background: Necrotizing fasciitis (NF) is a life-threatening soft tissue infection with rapid progression of necrosis. Early debridement and further surgical procedures are essential, but decision-making is often difficult. Serum interleukin-6 (IL-6) may serve as a valuable diagnostic parameter for monitoring the patient's state and may help in the selection of further therapeutic procedures. Case Summary: A 52-year-old man presented with a fever and severe pain in his left elbow. Laboratory tests showed streptococcal infection, septic shock, and extremely high IL-6 levels. Intensive care, including wide-spectrum antibiotics, rapid debridement, large-scale amputation, and continuous hemodiafiltration using polymethylmethacrylate (PMMA-CHDF), was performed to ensure the patient's survival. The serum IL-6 level was constantly monitored to assess the outcomes of therapeutic interventions. Conclusions: Real-time serum IL-6 levels may help assess the immune status of NF patients, guide therapeutic decisions as a part of a comprehensive evaluation, and not hesitate to amputate an extremity to save the patient's life.

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