Concurrent emphysematous pyelonephritis and thigh necrotizing fasciitis after intramuscular administration of diclofenac

Necrotizing fasciitis (NF) is a rapidly progressive,life-threatening soft tissue infection. NF may result from any injury to the skin or from hematogenous spread. However,con-current emphysematous pyelonephritis and necrotizing fasciitis of the left thigh has not been reported. We report a case of emphysematous pyelonephritis and necrotizing fasciitis of the left thigh after intramuscular administration of diclofenac that improved with aggressive management including broad-spectrum antibiotics,nephrectomy and surgical intervention.