Abstract

Neonatal necrotising fasciitis (NNF) is uncommon and often fatal bacterial soft tissue infection that affects skin, subcutaneous fat, superficial and deep fascia. It is characterised by rapid, extensive spread of inflammation and systemic toxicity and also associated with a high mortality. Wound cultures are usually polymicrobial with Staphylococcus aureus as the predominant organism. NNF occurrence in neonates is uncommon because plastibell do crush the prepuce between a suture and underlying bell which drops off in 5–8 days. Plastibell can strangulate the prepuce producing devitalised tissue that might be more susceptible to a serious infection especially if done under unhygienic condition. We present a 21-day old term male neonate who developed scrotal swelling subsequently followed by extensive gangrene of the scrotal sac following an illegal and unhygienic circumcision using a generally safe means (plastibel). Wound swab microscopy yielded mixed growth. However, the immediate outcome of the child was favourable. In conclusion, we recommend that simple as male circumcision is, it should be done by qualified individuals maintaining the highest standard feasible.