Diagnosis and management of necrotizing fasciitis

Hunter, John; Quarterman, Clare; Waseem, Mohammad; Wills, Alan

doi:10.12968/hmed.2011.72.7.391

Cited by 7 publications

(7 citation statements)

References 24 publications

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“…Hunter et al . suggest the combination of a carbapenem with clindamycin [10]. Otherwise, If cultures demonstrate sensitive Streptococcus pyogenes, there is a general agreement that a combination of penicillin G and clindamycin (high doses) is the prefered option.…”

Section: Discussionmentioning

confidence: 99%

Massive necrotizing fasciitis: a life threatening entity

Vilallonga

Mazarro

Rodríguez-Luna

et al. 2019

Journal of Surgical Case Reports

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Necrotizing fasciitis (NF) is a complicated soft tissue infection frequently associated with severe sepsis if an early medical and surgical treatment is not performed. We report two postoperative cases of severe NF after oophorectomy and colorectal resection. Because of the similarity with more benign skin infections at the early steps, clinical suspicion is crucial. Surgical exploration and resection will provide both the diagnosis confirming necrotizing infection of the fascia with vessels and treatment. Also, empirical broad-spectrum antibiotics must be initiated as soon as possible. Regardless of the presence of risk factors, NF is a condition with a high mortality rate and only an expeditious and undelayed treatment may improve the patient’s outcome. Surgical focus control requires wide and repeated resections, and planned reconstructive plastic surgery might be necessary.

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Section: Discussionmentioning

confidence: 99%

Massive necrotizing fasciitis: a life threatening entity

Vilallonga

Mazarro

Rodríguez-Luna

et al. 2019

Journal of Surgical Case Reports

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show abstract

“…Prompt diagnosis is imperative as necrotizing fasciitis is a surgical emergency. 5,26 In the United States, 500 to 1500 cases of necrotizing fasciitis occur each year. 27 Risk factors for necrotizing fasciitis include diabetes, peripheral vascular disease, malignancy, obesity, cirrhosis, renal failure, injection drug use, chronic corticosteroid therapy, alcohol abuse, malnutrition, and iatrogenic immunosuppression.…”

Section: Necrotizing Fasciitismentioning

confidence: 99%

“…27 Risk factors for necrotizing fasciitis include diabetes, peripheral vascular disease, malignancy, obesity, cirrhosis, renal failure, injection drug use, chronic corticosteroid therapy, alcohol abuse, malnutrition, and iatrogenic immunosuppression. 26,28 Necrotizing fasciitis may be polymicrobial or monomicrobial. Polymicrobial infection, also referred to as type I, is often due to multiple bacteria that originate from the bowel flora, typically including a mix of anaerobic and aerobic organisms.…”

Section: Necrotizing Fasciitismentioning

confidence: 99%

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A guide to the Tx of cellulitis and other soft-tissue infections

Clebak¹,

Reedy-Cooper

Partin³

et al. 2021

The Journal of Family Practice

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“…One research suggested that there were 18.1% NF inpatients with HAI [9]. Early diagnosis and rapid treatment can help prevent and reduce poor prognosis [10]; nevertheless, the diagnosis of NF is very difficult [11]. The initial signs and symptoms are often nonspecific until the patient rapidly deteriorates, and NF is commonly accompanied by shock and decreased level of consciousness [12].…”

Section: Introductionmentioning

confidence: 99%

Medicolegal implications from litigations involving necrotizing fasciitis

2020

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Necrotizing fasciitis (NF) is one of the most severe healthcare-associated infections. Early diagnosis of NF is difficult because of nonspecific signs and symptoms in the early stage. NF often presents with risks of medicolegal disputes. This study aimed to provide baseline data on the general characteristics of medical accidents involving NF, features of NF, and typical court opinions regarding medical malpractice in Korea. Methods: In this study, 25 cases of medical malpractice litigation involving NF sentenced between 1998 and 2018 were analyzed with respect to 3 variables: medical accident, NF, and breach of duty. Results: The department of colorectal surgery was most frequently involved in litigation cases (40.0%), and colorectal surgery was the most frequent procedure before the diagnosis of NF (40.0%). The most common sites were the upper and lower extremities. The courts agreed that there was typically improper monitoring after treatment, frequently related to NF. Conclusion: These litigation cases imply that physicians cannot be blamed for the failure to prevent NF. The timely recognition and management of NF might be considered as one of the main factors for deciding malpractice in court. Therefore, surgeons, especially in the department of colorectal surgery, should pay attention to changes in the patient's status after surgery. Surgeons need to learn from medical accidents, as it is important for risk management, preventing the occurrence of similar cases, and improving the quality of healthcare services. We report the medicolegal implications from medical lawsuits involving NF.

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Diagnosis and management of necrotizing fasciitis

Cited by 7 publications

References 24 publications

Massive necrotizing fasciitis: a life threatening entity

Massive necrotizing fasciitis: a life threatening entity

A guide to the Tx of cellulitis and other soft-tissue infections

Medicolegal implications from litigations involving necrotizing fasciitis

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