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PubMed2001

Necrotizing fasciitis.

Necrotizing fasciitis continues to occur due to beta-haemolytic streptococci but is now also recognized as being due to Vibrio spp. in fishermen and those in contact with warm water in the Gulf of Mexico and South-East Asia, including Hong Kong. Magnetic resonance image scanning has identified the extent of fasciitis and soft tissue oedema infiltrating fascial planes prior to necrosis presenting clinically and is a useful tool in early diagnosis. Surgical debridement or incisional drainage remains essential. An enhanced bactericidal response against beta-haemolytic streptococci has been found with a combination of penicillin and clindamycin. Intravenous immunoglobulin has been shown to reduce mortality if the necrotizing fasciitis is associated with the toxic shock syndrome, by decreasing the superantigen activity of the beta-haemolytic streptococci on cytokine release by T cells.

Adult↗

PubMed1997

Another cause of necrotizing fasciitis?

Necrotizing fasciitis is a rare condition, but has a devastating clinical course if it is not diagnosed early and treated aggressively. There are usually a number of organisms implicated in its pathogenesis, but in this case report a patient is presented in whom the only organism isolated from both tissue and blood cultures was Clostridium septicum. This organism almost always causes a myonecrosis, but in this case only the superficial and deep fascial layers were affected, sparing the underlying muscle. Clostridium septicum resulting in a true necrotizing fasciitis with no myonecrosis and being the only isolate from both blood and tissue cultures has not been previously reported in literature.

Aged↗

PubMed2000

Group A streptococcus necrotizing fasciitis.

Necrotizing fasciitis due to Group A streptococcus has been observed with increasing frequency over the past decade. Appropriate management requires rapid recognition of this life-threatening infection and expeditious antimicrobial therapy as well as surgical debridement or excision of tissue.

Adult↗

PubMed1996

Reconstruction of mandible and surrounding soft tissues in patient with necrotizing fasciitis.

Necrotizing fasciitis is rare in the orofacial region, with fewer than 20 cases reported in the literature. Extension of the disease process to involve the underlying bone has not been previously reported. A patient is presented in whom destruction of superficial skin and fascia, necrosis of a portion of the mandible, and involvement of the parotid gland complicated reconstruction.

Calcium Hydroxide↗

PubMed2006

Necrotizing fasciitis.

Necrotizing fasciitis is an uncommon, rapidly spreading infection, affecting primarily the deep fascia, which may result in secondary necrosis of the subcutaneous tissue, fascia and muscle. We report a patient that had the cardinal features; namely, excruciatingly painful lesions, demonstration of gas in the tissue and an obnoxious foul odor, prominent erythema, induration, patchy necrosis, and loss of sensation in the left buttock and thigh. Its onset probably followed inadvertent trauma/injury of the left buttock. Corroborative microscopic pathology confirmed the diagnosis. Debridement and intensive supportive therapy comprising antibiotics, analgesics and fluids were given. The outcome of the therapy was gratifying.

Aged↗

PubMed2003

Soft-tissue infection: necrotizing fasciitis.

Necrotizing fasciitis (NF) is a potentially fatal infection of the skin and soft tissue. The early presentation may first appear as cellulitis. The skin stays intact in the early stages of NF; this leads to a deceptive benign appearance. The skin typically appears red, hot and exquisitely tender. Blisters may or may not be present. Severe local pain, which is out of proportion to the size and type of wound, is a hallmark sign seen in NF. Recognition of the signs and symptoms, as well as timely diagnosis and treatment of this condition is imperative. This is necessary in order to assist in preventing widespread tissue destruction, and enhance favorable patient outcomes. The purpose of this paper is to increase the knowledge and understanding of NF and to discuss the nurses' role in minimizing unfavorable outcomes.

Fasciitis, Necrotizing↗

PubMed2004

Necrotizing fasciitis.

Necrotizing fasciitis (NF) is a rare but rapidly progressive and potentially fatal disease condition. It is characterized by progressive inflammation and extensive necrosis of the subcutaneous tissue and fascia, sparing the underlying tissue. It is a poly-bacterial infection and is associated with profound systemic toxicity, considerable morbidity and a high mortality rate. The outcome is influenced by early recognition and radical surgical debridement. We present a report of six cases of NF who presented to our surgical service within the past 5 years.

Adolescent↗

PubMed1998

[Cervical necrotizing fasciitis].

Necrotizing fasciitis is a severe fatal soft tissue infection characterized by necrosis of fascia. It was caused by polymicrobial infections with aerobe and anaerobe. Although it commonly involved abdomen, extremities and perineum, it might also occur in head and neck. One case of CNF arising from pharyngolaryngitis was reported. A review of the literature with the clinical presentations, bacteriology, diagnosis and treatment was presented. The key to successful management is early recognition, broad-spectrum antibiotics and prompt aggressive surgical intervention with medical support and hyperbaric oxygen therapy.

Fasciitis, Necrotizing↗

PubMed2001

[Hyperbaric oxygen for the treatment of necrotizing fasciitis].

Necrotizing fasciitis (NF) is a severe often life threatening bacterial infection. There are 2 main reasons to use hyperbaric oxygen (HBO2): the polymorphism of the bacterial flora with a predominance of anaerobes, either strict or aerotolerant; and the tissular necrosis due to an extensive disseminated microvascular obstruction within the infected area. Association of HBO2 to antibiotics and surgery is based on strong pathophysiological findings as well as on evidences from animal studies. Clinical evidence in human is still lacking even if published data supports its use in severe cases. Controversy on its use as a treatment for NF is caused more by the difficulty to dispose of a hyperbaric equipment allowing for the management of a patient in critical state, than by doubt on its real efficiency.

Animals↗

PubMed1997

[Necrotizing fasciitis].

Necrotizing fasciitis has changed considerably over time. The disease used to be due to group A streptococci and affected otherwise quite healthy or traumatized subjects. Today we see multibacterial infections in polymorbid or immunocompromised patients. Rapid and resolute surgery is of critical prognostic value. Early clinical recognition may be difficult. Sometimes frozen-section biopsy proves helpful. Septic immune response and organ failure develop rapidly in these patients. After vigorous staged necrosectomy, extensive plastic reconstruction is mostly required.

Debridement↗

PubMed1987

A de novo case of vulvar synergistic necrotizing fasciitis.

Necrotizing fasciitis is an uncommon but potentially lethal soft tissue infection. Reports of this entity in the obstetric patient exist. We present a case of necrotizing fasciitis arising de novo in the vulva. Early diagnosis and radical surgical debridement are the hallmarks of successful treatment.

Adult↗

PubMedDate not supplied

Necrotizing fasciitis.

Necrotizing fasciitis can be a devastating infectious process when diagnosis and early aggressive therapy is delayed. The etiologic factors that may play a role in or affect this necrotizing infectious process are reviewed. An interesting case is presented of bilateral, lower extremity, necrotizing fasciitis in a patient with diabetes mellitus, peripheral vascular disease and profound sensory neuropathy.

Amputation, Surgical↗

PubMed2003

Anesthetic implications of necrotizing fasciitis.

Necrotizing fasciitis, also known as necrotizing acute soft tissue injury (NASTI), commonly occurs as a consequence of group A streptococcal disease. An estimated 9,400 cases of invasive group A streptococcal disease occur annually in the United States, with 600 cases classified as NASTI. Mortality associated with NASTI is estimated at 20% to 50%. Research indicates that early diagnosis and surgical excision of necrotic tissue is the key to minimalization of morbidity and mortality associated with NASTI. Repeated surgeries typically are required in patients with NASTI, posing unusual anesthetic challenges. This article provides an overview of NASTI and includes preoperative, intraoperative, and postoperative anesthetic considerations.

Anesthesia↗

PubMed1980

Postpartum necrotizing fasciitis.

Necrotizing fasciitis, a rare complication in obstetrics, often presents as a fulminating disease with a markedly high mortality. Systemic antibiotics alone do not substantially alter the mortality. Successful treatment rests in early diagnosis, wide surgical debridement of necrotic tissue, and drainage. This report reviews the literature and presents a case of postpartum necrotizing fasciitis.

Adolescent↗

PubMed1993

Diffuse abdominal wall cellulitis in ascending omphalitis--a lethal association in neonatal necrotizing fasciitis.

Necrotizing fasciitis is a grave complication of ascending omphalitis in the neonate, but because it is rare some of the signs are not well documented. Rapidly progressive anterior abdominal wall edema and cellulitis were noted in 16 patients who were clinically diagnosed with necrotizing fasciitis. Fifteen of these patients died soon after emergence of anterior abdominal wall edema and cellulitis. The appearance of anterior abdominal edema and cellulitis in a patient with ascending omphalitis has serious implications and demands intensive care if the patient is to survive.

Abdominal Muscles↗

PubMed1990

Odontogenic cervical necrotizing fasciitis.

Necrotizing fasciitis is a severe soft-tissue infection characterized by diffuse necrosis of fascia and subcutaneous tissue; initially, skin and muscle are usually spared. The trunk, abdomen, perineum, and extremities are the most commonly involved areas. The case of a 55-year-old man with a cervical necrotizing fasciitis from an infected tooth is presented. The medical history, etiology, anatomy, precipitating factors, clinical presentation, and therapy of this infection are discussed. Early recognition allows effective therapy with aggressive surgical intervention, broad-spectrum antibiotics, and supportive care. Misdiagnosis (eg, as cellulitis) and delayed surgical treatment can result in severe systemic toxicity and a mortality rate that approaches 40%.

Anti-Bacterial Agents↗

PubMed1994

[Cervical necrotizing fasciitis].

Necrotizing fasciitis of the head and neck is a rare infection caused by a mixed bacterial flora with anaerobic predominance. Mortality is due to misdiagnosis which results in late and inadequate treatment. The natural course of this serious infection involves spreading necrosis of the soft tissues of the neck with erosion of major blood vessels. A 33-year-old man and a 66-year-old woman are presented to demonstrate the usual etiological factors of cervical necrotizing fasciitis, mainly dental and pharyngeal infections. Diagnosis is by bacteriological culture and CT-scan; a high degree of clinical suspicion is necessary. Treatment included aggressive surgery, appropriate antibiotic coverage and hyperbaric oxygen, and resulted in successful outcomes in our 2 cases.

Adult↗

PubMed1977

Necrotizing fasciitis.

Necrotizing fasciitis is a relatively uncommon severe soft tissue infection that is characterized by rapid widespread superficial fascial necrosis with undermining of surrounding soft tissue. Recent advances in anaerobic culture techniques have allowed identification of anaerobic organisms, which are now considered to have a vital role in the pathogenesis of this soft tissue infection. Therapy requires both rapid institution of a high level of antibiotics and a radical surgical incision and drainage procedure. All of the aerobic and anaerobic organisms isolated in the reported case of necrotizing fasciitis arising from a periapically infected mandibular third molar demonstrated in vitro sensitivity to penicillin.

Adult↗