Above-knee amputation in a 69-year-old male with gouty tophi complicated by necrotising 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 a swollen, erythematous, and painful joint. Necrotising fasciitis is rapidly progressing aggressive soft tissue infection that spreads along the fascial planes sparing the skin; it is very uncommon for necrotising fasciitis to occur as a complication of gouty arthritis. We present here a case of a 69-year-old male with a known history of untreated gouty arthritis and tophi over the right foot that complicated into necrtotising fasciits of the leg with extension to the upper thigh, which was surgically debrided but also necessitated above-knee amputation for infection control, survival, and best possible functional outcome of the patient.