Hematologic malignancies combined with acute necrotizing fasciitis: a report of 3 cases and literature review

A retrospective analysis was conducted on the clinical data of 3 patients with hematologic malignancies complicated with necrotizing fasciitis (NF) admitted to the Hematology Department of Tianjin Union Medical Center in June 2021, March 2024, and November 2024. Also, according to search results for relevant literature on hematological malignancies combined with necrotizing fasciitis published before October 2025, 6 articles (6 cases) were included. Among them, 6 were male and 3 were female, with ages ranging from 4 days to 76 years. All 9 patients presented with fever accompanied by local swelling and pain. Comprehensive imaging examinations (e.g., CT, MRI) were conducted on all cases to confirm NF, with perianal infection, limb soft tissue infection, perineal infection, and external oblique muscle infection identified in 3, 4, 1, and 1 cases, respectively. Among the 9 patients, one infant patient died after not continuing treatment following anti-infective therapy. The remaining 8 patients all received treatment for this disease along with active anti-infection and surgical debridement therapy. One patient died of septic shock, and 7 showed improvements (leukemia remission, infection control, and wound recovery). For patients with hematologic malignancies and NF, surgical debridement should be performed as soon as possible after diagnosis. Early broad-spectrum antibiotics combined with anti-infection treatment should be administered, with the anti-infection treatment adjusted based on the drug sensitivity evidence of the pathogenic bacteria.