Clinical evaluation of forty-four patients with necrotizing fasciitis

Abstract

AMAÇNekrotizan fasiit, nadir görülen ancak hayatı tehdit eden, esas olarak yüzeyel fasiya ve deri altı dokuyu tutan bir yumuşak doku enfeksiyonudur. GEREÇ VE YÖNTEMBu çalışmada 2004-2008 yılları arasında nekrotizan fasiit tanısıyla Akdeniz Üniversitesi Tıp Fakültesi İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji servisinde yatan ve diğer kliniklerde yatarken enfeksiyon hastalıkları ve klinik mikrobiyoloji konsültasyonlarıyla takip ve tedavi edilen 44 hasta retrospektif olarak incelendi. Hastanemizdeki etkenlerin dağılı-mı, yerleşim yeri, eşlik eden hastalıklar ve risk faktörlerinin ortaya konulması amaçlandı. BULGULARÇalışmamız sonucunda diyabetes mellitus, travma ve cerrahi, nekrotizan fasiit oluşumunda rol oynayan predispozan faktör-ler arasında yer alırken en sık alt ekstremitede ve perianal böl-gede yerleştiği tespit edildi. Etyolojide polimikrobiyal etkenler ilk sırada yer alırken mortalite oranı %25 olarak saptandı. SONUÇBu çalışmayla enfeksiyon acilleri arasında yer alan nekrotizan fasiit olgularının hastanemizdeki izlem sonuçları değerlendirilmiştir.Anahtar Sözcükler: Deri yumuşak doku; fasiit; nekrotizan fasiit.

Laboratory Risk Indicators for Necrotizing Fasciitis and Associations with Mortality

“…The studies show that NF is more common in males aged 50–60. 3 , 4 , 16 In our series, the average age of patients was 55.6; our study was found to be consistent with the literature. Although male patients’ rates are higher in case series, female patient dominance was observed in the series of Tilkorn and colleagues, similar to our series.…”

“…The common predisposing factors are trauma, previous operations, and perianal abscess; in addition, perforated appendicitis, burns, insect bites, intravenous injection, and intramuscular injection seen after NF cases are also reported. 2 , 3 , 4 , 15 , 16 , 17 , 18 In our study, we also detected soft tissue infections, perianal abscess, perforation of hollow organs, previous surgery, and trauma as the most common predisposing factors. In 4 patients who did not have detectible predisposing factors, we found the co-morbid diseases DM and PVH.…”

“… [15] The most common co-morbid diseases observed in NF are DM, immunosuppression, chronic renal failure, the underlying malignancy, atherosclerosis, chronic obstructive pulmonary disease, and obesity. 2 , 3 , 4 , 15 , 16 In our study, the most common co-morbid disease was DM (52%). The common predisposing factors are trauma, previous operations, and perianal abscess; in addition, perforated appendicitis, burns, insect bites, intravenous injection, and intramuscular injection seen after NF cases are also reported.…”

“…[1] Urogenital-anorectal infection and trauma plays an important role etiologically. 2 , 3 , 4 However, NF may be caused by minor injuries such as tissue abrasions and lacerations, insect bites, and intramuscular injection; it also should be considered that there may not always be a detectable cause. 5 , 6 , 7 , 8 Despite immediate surgical intervention and antibiotic therapy, the mortality rate is about 20–30%.…”

“… 5 , 6 , 7 , 8 Despite immediate surgical intervention and antibiotic therapy, the mortality rate is about 20–30%. 3 , 4 , 9 …”