# Necrotizing Fasciitis Occurring After a Conventional Tattoo

## TL;DR

A 34-year-old patient developed necrotizing fasciitis after a conventional tattoo, highlighting the risk of infection even with licensed and modern tattoo practices.

## Contribution

This is the first reported case of necrotizing fasciitis after a conventional tattoo in Belgium.

## Key findings

- The infection occurred despite the use of modern tools by a licensed tattoo artist.
- The patient recovered after fasciotomy, antibiotics, and vacuum-assisted closure therapy.
- The cause was attributed to poor hygiene rather than the tattoo method itself.

## Abstract

A 34-year-old patient presented to the emergency department after getting a tattoo from a licensed tattoo artist at home. The patient was in septic shock with renal failure, and the clinical examination revealed a skin infection at the tattoo site. Suspecting necrotizing fasciitis, the patient underwent fasciotomy with deep tissue sampling and vacuum-assisted closure therapy. Broad-spectrum antibiotic therapy was initiated and later adjusted based on bacterial culture results. The patient quickly recovered and was discharged from the intensive care unit.

We report the first case of post-conventional tattoo necrotizing fasciitis in Belgium. The tattoo was performed by a professional licensed tattoo artist, equipped as required by Western legislation. Previously reported cases highlighted necrotizing fasciitis occurring after Samoan or Samoan-style tattoos, an ancestral practice with handmade tools. In our case, the tattoo was done in a conventional way with modern tools and techniques. It is the lack of hygiene precautions that we can attribute to the development of this serious pathology.