Background - Necrotizing fasciitis is a subset of aggressive skin and soft tissue infections (SSTIs) that cause necrosis of the muscle fascia and subcutaneous tissues. The infection typically travels along the fascial plane, which has a poor blood supply. Failure to obtain early diagnosis and delay in initiating appropriate treatment can lead to significant mortality and morbidity.

Case report –  Our patient was a23year old women, G4 A3 with 35 weeks+4 days of gestation with history of recurrent pregnancy loss came with complains of leaking per vagina since 6 hours. Patient was taken up for emergency Caesarean section as NST was non-reactive. On day 4, patient complained of pain at suture site and was febrile, hyperpigmentation was noted surrounding the suture site. Higher antibiotics were started and on day 5 wound was suggestive of necrotising fasciitis, patient was shifted to ICU and managed accordingly. This case report illustrates the challenging diagnosis and management of a case of necrotizing fasciitis.

Discussion - Necrotizing fasciitis following caesarean section is extremely rare with an incidence of 2 in 1000. Necrotizing fasciitis is rapidly spreading and is fatal if left untreated. High index of suspicion and early diagnosis, combined with surgical debridement and broad spectrum antibiotic therapy are required. Clinicians must quickly recognize the distinction between cellulitis manageable with antimicrobial therapy and Necrotizing Fasciitis requiring surgical intervention