Above-Knee Amputation in a 69-Year-Old Male with Gouty Tophi Complicated by Necrotizing Fasciitis - A Case Report

Gout is the most prevalent form of inflammatory arthritis in males as a result of high uric acid levels that cause deposition of monosodium urate crystals in soft tissues, bones and joints. It commonly presents as swollen, erythematous and painful joint. Necrotizing fasciitis is rapidly progressing aggressive soft tissue infection that spreads along the fascial planes sparing the skin; it is very uncommon for necrotizing fasciitis to occur as a complication of gouty arthritis. We present here a case of a 69 year old male with known history of untreated gouty arthritis and tophi over the right foot that complicated into necrtotizing fasciits of the leg with extension to the upper thigh that was surgically debrided but also necessitated above knee amputation for infection control, survival and best possible functional outcome of the patient.