Necrotizing fasciitis as complication of combined use of bevacizumab with chemotherapy

Abstract

Necrotizing fasciitis (NF) is an uncommon, severe, life-threatening soft tissue infection involving the subcutaneous tissue. Immunocompromised and patients with diabetes are at a higher risk of developing NF. One of the pathophysiologic mechanisms of NF is subcutaneous arterie thrombosis and tissue ischemia. Bevacizumab, a agent used in cancer treatment, blocks the activity of the vascular endothelial growth factor receptor. Recently, it is used along with paclitaxel and carboplatin due to an increased survival rate. The frequent use of this combination caused patients to applied to the emergency department (ED) with some side effects. NF is one of the rare side effects of this combination. Here, we present a patient with ovarian cancer who was admitted to the ED with severe leg pain, whose initial examination and tests were normal, and then NF developed within hours and then arrested.