A Very Uncommon Complication Following Vaccination: Necrotizing Fasciitis and Myonecrosis: Case Report

Necrotizing fasciitis (NF) and myonecrosis is a potentially lethal soft tissue infection characterized by extensive muscular, fascial and subcutaneous tissue necrosis. In this paper, we report an 18-month-old boy admitted to a health clinic three days after Hepatitis-B vaccine injection with cellulitis at his left lateral arm and axilla. He was recommended oral antibiotics, however in the fifth day after vaccination he became lethargic, there were pseudo-paralysis, edema, crepitus on palpation and cutaneous necrosis was observed at axillary region and at posterior arm. With the diagnosis NF and myonecrosis, all the necrotic tissue including pectoralis major, triceps brachii, and most of the rotator cuff muscles were excised. After cutaneous grafting, the wounds healed, but functional recovery of the shoulder joint was poor at 4 year follow-up. Early diagnosis of NF and myonecrosis with debridment of necrotic tissue can prevent severe life threatening complications