Article

Necrotizing Fasciitis

Rollins School of Public Health, Emory University, Georgia, Atlanta, USA.
Internal Medicine (Impact Factor: 0.97). 01/2010; 49(12):1051-7. DOI: 10.2169/internalmedicine.49.2964
Source: PubMed

ABSTRACT Necrotizing fasciitis (NF) is a necrotizing soft tissue infection that can cause rapid local tissue destruction, necrosis and life-threatening severe sepsis. Predisposing conditions for NF include diabetes, malignancy, alcohol abuse, and chronic liver and kidney diseases. NF is classified into two categories (types 1 and 2) based on causative microorganisms. The initial clinical picture of NF mimics that of cellulitis or erysipelas, including fever, pain, tenderness, swelling and erythema. The cardinal manifestations of NF are severe pain at onset out of proportion to local findings, hemorrhagic bullae and/or vital sign abnormality. In such cases, NF should be strongly suspected and immediate surgical intervention should be considered, along with broad-spectrum antimicrobials and general supportive measures, regardless of the findings of imaging tests.

0 Followers
 · 
143 Views
  • Source
    • "Type 1 NF is characterized by polymicrobial, synergistic infections that are caused by non-Group-A streptococci, aerobic and anaerobic organisms [1]. Type 2 NF involves Group A Streptococcus (GAS) with or without a coexisting staphylococcal infection [2]. While the clinical manifestations are similar, type 1 and type 2 NF tend to affect different subgroups of patients. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Necrotizing fasciitis is a life-threatening soft tissue infection that results in rapid local tissue destruction. Type 1 necrotizing fasciitis is characterized by polymicrobial, synergistic infections that are caused by non-Group A streptococci, aerobic and anaerobic organisms. Type 2 necrotizing fasciitis involves Group A Streptococcus (GAS) with or without a coexisting staphylococcal infection. Here we provide the first report of necrotizing fasciitis jointly associated with the microbes Group B Streptococcus and Staphylococcus lugdunensis. S. lugdunensis is a commensal human skin bacterium known to cause often painful and prolonged skin and soft tissue infections. To our knowledge, however, this is the first case of Staph. lugdunensis-associated necrotizing fasciitis to be reported in the literature.
    05/2012; 2012:453685. DOI:10.1155/2012/453685
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Necrotizing fasciitis (NF) is a rare, rapidly progressive and potentially fatal soft-tissue infection characterized by widespread severe infection of the deep soft tissue, including fascia. Predisposing conditions for NF include diabetes, malignancy, obesity, and chronic liver disease. Patients with suspected NF should be empirically and immediately managed with broad-spectrum antibiotics covering the commonly suspected organisms. And surgical debridement is the mainstay of treatment of NF. We experienced a very rare case of NF with 33-year-old healthy woman who presented with high fever, erythema, edema, and pustule on upper abdomen one day after cesarean section. NF was strongly suspected and immediate surgical intervention and broad spectrum antibiotics were used. We report it with a brief review of literatures.
    01/2012; 55(9). DOI:10.5468/KJOG.2012.55.9.659
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Background: Necrotizing Fasciitis (NF) is a necrotizing soft tissue infection involving the fascia and subcutaneous tissue that can cause rapid local tissue necrosis and life-threatening severe sepsis. Aim: This article aims to review the aetiopathogenesis, investigations and management based on a literature review. Methods and Materials: The Medline literature search of relevant articles restricted to English language on necrotizing fasciitis was conducted and reviewed. Results: Necrotizing fasciitis is rare with an incidence ranging from 0.15 to 0.55 cases per 100,000 of the population. Accurate assessment and timely intervention are critical in the treatment of patients affected with NF. Understanding the history and unique characteristics of this disease is crucial to achieve early recognition, effective treatment and a favorable outcome. Classic symptoms include severe pain out of proportion to local findings, erythema, mottling, crepitus, skin anesthesia, warmth, tenderness, hemorrhagic bullous formation, edema in the affected area and fever. Predisposing conditions of NF are classified into 2 main categories (type I and II) based on causative microorganisms. Radical surgical debridement, broad spectrum antibiotics, negative pressure wound dressings, and hyperbaric oxygen therapy are considered to be the cornerstone of treatment. The mortality rate ranges widely from 10% to 75% and is related to delay in initial debridement, patient age of more than 60 years, associated hypotension, acidosis, bacteremia, renal failure, hyponatremia, peripheral vascular disease, myonecrosis and myositis. Conclusion: Necrotizing fasciitis is a devastating infection of the fascia and subcutaneous tissue. The presentation of the disease is nonspecific and variable. Delay in recognition and effective treatment increases the mortality. Prompt radical surgical debridement, appropriate antibiotics and adjuvant therapy contribute to an improved outcome.
    01/2011; DOI:10.4297/najms.2011.3107
Show more

Preview

Download
9 Downloads