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At least 19 recordsLinked to original sources

PubMed1996

[Multiple myeloma complicated by necrotizing fasciitis].

Necrotizing fasciitis is a rare but often fatal soft-tissue infection primarily involving the superficial fascia and fat tissue resulting in extensive undermining of surrounding tissues. Skin is initially spared, but as necrotizing fasciitis spreads, all the soft-tissue components, including the skin, become involved. The progression of necrotizing fasciitis is often fulminant, and the prognosis depends to a large extent on the rapidity of correct diagnosis and surgical treatment (debridement). Most of the patients affected with necrotizing fasciitis have some risk factors: chronic general or local diseases, leukopenia, immunodeficiency diseases, malignancies, and an age of 50 years or more. The author reported the occurrence of necrotizing fasciitis in a 69-year-old man with multiple myeloma during the granulocytopenic phase after chemotherapy. The successful treatment of necrotizing fasciitis in the present case relied not only on surgical debridement, but also on G-CSF administration.

Aged↗

PubMed1999

Cervical necrotizing fasciitis.

Necrotizing fasciitis is a severe soft tissue infection that results in necrosis of the fasciae and subcutaneous tissues; the infection can quickly prove fatal. Although involvement of the head and neck is rare, causes are usually odontogenic or pharyngeal but can also be insect bites, local trauma, burns or surgery. We present a clinical case of a 31-year-old Italian woman with cervical necrotizing fasciitis having an uncommon presentation. While under treatment, the patient's husband was admitted for necrotizing fasciitis of the medial fasciae of his left leg subsequent to an insect sting. The causes, diagnosis and treatment of necrotizing fasciitis are reviewed.

Adult↗

PubMed1983

Necrotizing fasciitis.

Necrotizing fasciitis has long been recognized as an acute life-threatening infection requiring aggressive treatment. It generally occurs after minor trauma, but often there is no history of injury. The skin in necrotizing fasciitis is pale or red with no clear line of demarcation between affected and normal skin. There is extensive undermining of the skin with a foul-smelling sanguineous exudate. The superficial fascia and the deep fascia can be easily separated and will appear stringy, ragged, and dull gray to gray-green in color. Muscle, bone, or viseral involvement is not a feature of necrotizing fasciitis. The systemic response is one of an acutely ill patient with prostration and clouding of sensorium. Anemia, low serum calcium level, and fluid volume deficits are commonly seen along with other nonspecific laboratory and clinical findings common to serious acute infections. Necrotizing fasciitis is a polymicrobial disorder and not a specific bacterial infection. Beta-hemolytic streptococci, Staphylococcus aureus, and mixed gram-negative organisms are most frequently reported as etiologic agents, with more recent reports usually demonstrating a combination of anaerobic and facultative anaerobic bacteria. The primary therapy consists of radical surgical debridement of all nonviable tissue with frequent postoperative checks to monitor for further dissection that would require additional surfical debridement. Local wound care consists of diligent cleaning and application of loose gauze soaked with a topical agent. Parenteral antibiotic therapy based upon the Gram stain and further modified on the basis of bacterial culture and sensitivity studies, is started immediately. Management also involves correction of fluid and electrolyte imbalances, correction of anemia, and general supportive care.(ABSTRACT TRUNCATED AT 250 WORDS)

Debridement↗

PubMed1996

Necrotizing fasciitis.

Necrotizing fasciitis is an uncommon soft-tissue infection, usually caused by toxin-producing, virulent bacteria, which is characterized by widespread fascial necrosis with relative sparing of skin and underlying muscle. It is accompanied by local pain, fever, and systemic toxicity and is often fatal unless promptly recognized and aggressively treated. The disease occurs more frequently in diabetics, alcoholics, immunosuppressed patients, i.v. drug users, and patients with peripheral vascular disease, although it also occurs in young, previously healthy individuals. Although it can occur in any region of the body, the abdominal wall, perineum, and extremities are the most common sites of infection. Introduction of the pathogen into the subcutaneous space occurs via disruption of the overlying skin or by hematogenous spread from a distant site of infection. Polymicrobial necrotizing fasciitis is usually caused by enteric pathogens, whereas monomicrobial necrotizing fasciitis is usually due to skin flora. Tissue damage and systemic toxicity are believed to result from the release of endogenous cytokines and bacterial toxins. Due to the paucity of skin findings early in the disease, diagnosis is often extremely difficult and relies on a high index of suspicion. Definitive diagnosis is made at surgery by demonstration of a lack of resistance of normally adherent fascia to blunt dissection. Treatment modalities include surgery, antibiotics, supportive care, and hyperbaric oxygen. Early and adequate surgical debridement and fasciotomy have been associated with improved survival. Initial antibiotic therapy should include broad aerobic and anaerobic coverage. If available, hyperbaric oxygen therapy should be considered, although to our knowledge, there are no prospective, randomized clinical trials to support this. Mortality rates are as high as 76%. Delays in diagnosis and/or treatment correlate with poor outcome, with the cause of death being overwhelming sepsis syndrome and/or multiple organ system failure.

Fasciitis, Necrotizing↗

PubMed1994

Pyoderma gangrenosum complicated by necrotizing fasciitis.

Necrotizing fasciitis is a potentially life-threatening infection that may resemble extensive pyoderma gangrenosum. The treatment of the two diseases is, however, different, and differentiating them is therefore essential. A case is presented in which necrotizing fasciitis appeared as a complication of pyoderma gangrenosum. The successful treatment is described, and the differential diagnosis of the two entities is presented. The need for early and aggressive treatment of necrotizing fasciitis is stressed.

Aged↗

PubMed1992

Retroperitoneal necrotizing fasciitis.

Necrotizing fasciitis is a mixed infection of the skin and subcutaneous tissues with a characteristic clinical and pathological appearance. Early radical surgical excision of all affected tissue is the treatment of choice. In a series of 19 patients with necrotizing fasciitis, bacteriological assessment in 15 confirmed the mixed nature of the infection, with Bacteroides sp. isolated from ten patients. All 12 patients who underwent radical surgical excision survived. A subgroup of patients was identified in whom the appearance of necrotizing fasciitis in the abdomen or perineum was indicative of more extensive disease in the retroperitoneal tissues. Surgical resection of all affected tissue was not feasible in these cases and the outcome was uniformly fatal, giving an overall mortality rate for the series of 37 per cent.

Aged↗

PubMed1998

[Necrotizing fasciitis].

Necrotizing fasciitis is a rare soft tissue infection with a high rate of mortality. Decreased capacity of the immune response is the overall disposing factor. Necrotizing fasciitis can develop very rapidly, and a rapid diagnosis and aggressive surgery provides the best prognosis.

Amputation, Surgical↗

PubMed1996

Necrotizing fasciitis.

Necrotizing fasciitis is a life-threatening, invasive soft-tissue infection that is characterized by widespread, rapidly developing necrosis of the subcutaneous tissue and fascia. It is more likely to occur in patients with a compromised immune system. In type I necrotizing fasciitis, anaerobes and gram-negative bacteria are predominant; in the type II form, the bacterial etiology is group A beta-hemolytic streptococci. The diagnosis must be made on the basis of clinical grounds and is characterized by rapidly developing, painful erythema that progresses to bullous formation and gangrenous necrosis.

Adult↗

PubMed1996

Necrotizing fasciitis.

Necrotizing fasciitis is a rapidly progressing soft-tissue infection characterized by extensive necrosis of subcutaneous fat and fascia. It is frequently accompanied by moderate to severe systemic toxicity and can be fatal without prompt recognition and aggressive surgical treatment. The podiatric physician must be aware of these infections because the extremities are common sites of involvement. Necrotizing, fasciitis must be treated as a medical emergency calling for prompt surgical intervention and high doses of broad-spectrum antibiotics.

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↗

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↗

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↗

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↗