When it’s not necrotizing fasciitis: a case of benign subcutaneous emphysema

Abstract

A 54-year-old woman presented with hand swelling 15 hours after sustaining a superficial incision between her fingers with a letter opener. She was afebrile and reported minimal pain. Examination revealed crepitus extending from the dorsum of the hand to the forearm, without inflammatory signs. Radiographs showed subcutaneous emphysema without fascial involvement, and inflammatory markers were normal. Infectious causes such as necrotizing fasciitis were excluded, and a diagnosis of benign subcutaneous emphysema was made. The patient recovered fully with immobilization and prophylactic antibiotics.