Amputation of lower limb for necrotizing soft-tissue infection in an ultramarathon runner

SummaryNecrotizing soft-tissue infection (NSTI) is a life-threatening disease with rapid progression, which has rarely been discussed in the medical literature with regard to marathon runners. We present the case of a 51-year-old Taiwanese woman, a female ultramarathon runner who had a medical disaster after her participation in La Trans-Gaule French ultramarathon. After completing the competition, she was diagnosed to have septicemia and a potentially life-threatening NSTI of both lower limbs. Therefore, she underwent emergent right above-the-knee amputation and left foot transmetatarsal amputation. Then she came back to Taiwan to receive further treatment. After meticulous reconstructive surgery and continuous rehabilitation programs, she was instructed to wear prostheses and finally resumed her daily activities. Although several organ systems can be affected by marathon running, soft-tissue infections have seldom been discussed. In our case, the patient suffered from bilateral lower limb amputation caused by severe necrotizing infection after the competition. Thus, soft-tissue infection is also an important issue for ultramarathon runners and medical service providers from ultramarathon associations.