Necrotizing Fasciitis
- 1 March 2009
- journal article
- review article
- Published by Ovid Technologies (Wolters Kluwer Health) in Journal of the American Academy of Orthopaedic Surgeons
- Vol. 17 (3), 174-182
- https://doi.org/10.5435/00124635-200903000-00006
Abstract
Necrotizing fasciitis is a rare but life-threatening soft-tissue infection characterized by rapidly spreading inflammation and subsequent necrosis of the fascial planes and surrounding tissue. Infection typically follows trauma, although the inciting insult may be as minor as a scrape or an insect bite. Often caused by toxin-producing, virulent bacteria such as group A streptococcus and associated with severe systemic toxicity, necrotizing fasciitis is rapidly fatal unless diagnosed promptly and treated aggressively. Necrotizing fasciitis is often initially misdiagnosed as a more benign soft-tissue infection. The single most important variable influencing mortality is time to surgical débridement. Thus, a high degree of clinical suspicion is necessary to avert potentially disastrous consequences. Orthopaedic surgeons are often the first to evaluate patients with necrotizing fasciitis and as such must be aware of the presentation and management of this disease. Timely diagnosis, broad-spectrum antibiotic therapy, and aggressive surgical débridement of affected tissue are keys to the treatment of this serious, often life-threatening infection.Keywords
This publication has 41 references indexed in Scilit:
- SevereStreptococcus pyogenesInfections, United Kingdom, 2003–2004Emerging Infectious Diseases, 2008
- Community Associated Methicillin Resistant Staphylococcus Aureus Causing Fournier’s Gangrene and Genital InfectionsJournal of Urology, 2007
- Group A streptococcal infections of the skin: molecular advances but limited therapeutic progressCurrent Opinion in Infectious Diseases, 2006
- The use of Integra™ in necrotizing fasciitisClinical Dermatology and Surgery, 2006
- Necrotizing fasciitis: a deadly infectionJournal of the European Academy of Dermatology and Venereology, 2006
- Life-threatening necrotizing fasciitisClinics in Dermatology, 2005
- Necrotizing Fasciitis Caused by Community-Associated Methicillin-ResistantStaphylococcus aureusin Los AngelesThe New England Journal of Medicine, 2005
- Necrotising fasciitis: a new management algorithm based on clinical classificationInternational Wound Journal, 2004
- A simple model to help distinguish necrotizing fasciitis from nonnecrotizing soft tissue infectionJournal of the American College of Surgeons, 2000
- Streptococcal necrotizing fasciitis and the dermatologistBritish Journal of Dermatology, 1999