Necrotizing fasciitis – a review

Salati, Sajad Ahmad

doi:10.5604/01.3001.0015.7676

Cited by 17 publications

(19 citation statements)

References 39 publications

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“…Moreover, differential diagnosis of CNF from non-necrotizing deep neck infections may be difficult at early stages, since these two entities are clinically similar initially [8,9]. An accurate diagnosis at the time of presentation is reached in less than 40% of the patients [25]. The presence of blistering and bullae has been signaled as an important distinguishing feature from other non-necrotizing infections such as erysipelas or cellulitis.…”

Section: Clinical Diagnosismentioning

confidence: 99%

Cervical Necrotizing Fasciitis: a life-threatening emergency in Oral and Maxillofacial Surgery

De Leyva,

Cárdenas-Serres,

Ranz-Colio

et al. 2023

Preprint

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Necrotizing fasciitis is a life-threatening soft-tissue infection affecting the deep fascia and subcutaneous tissue. It is characterized by a fulminant course and high mortality rates. NF of the head and neck is very rare, most cases being odontogenic in origin. Streptococcus spp. and Staphylococcus spp. are the most common isolated organisms. If the infection progresses to descending mediastinitis the prognosis becomes very poor. Since the initial clinical features can be similar to those of a non-necrotizing deep cervical infection, a high degree of suspicion is critical for an early diagnosis. Computed tomography scan can be useful in the diagnosis and to define the extent of the infection. Early and aggressive surgical debridement of all compromised tissue and antibiotic therapy and fluid resuscitation are essential and should not wait for bacterial culture results. Despite prompt and adequate treatment, mortality of CNF can be as high as 35%.

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Section: Clinical Diagnosismentioning

confidence: 99%

Cervical Necrotizing Fasciitis: a life-threatening emergency in Oral and Maxillofacial Surgery

De Leyva,

Cárdenas-Serres,

Ranz-Colio

et al. 2023

Preprint

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“…Its incidence is rare, with approximately 4 per 100,000 people per year, with the condition being most frequently diagnosed in individuals between 50 and 60 years of age, with a higher prevalence in men [2]. Risk factors include diabetes, immunosuppression, malnutrition, advanced age, non-steroidal anti-in ammatory drugs (NSAID) use, morbid obesity, liver cirrhosis, alcoholism, chronic renal failure, HIV/AIDS, and underlying malignancy [3]. Notably, patients with diabetes and obese individuals account for 22-59% and 17-31% of all cases, respectively.…”

Section: Introductionmentioning

confidence: 99%

Necrotising fasciitis with extensive necrosis caused by Lactobacillus: A case report

Nagayama,

Sao,

Takanori

et al. 2024

Preprint

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Background Necrotising fasciitis (NF) is a life-threatening soft-tissue infection that rapidly destroys the epidermis, subcutaneous tissue, and fascia. Despite their low virulence, Lactobacillus spp. can cause NF, and because of its rare incidence, there is limited knowledge about its molecular and clinicopathological characteristics. We report a rare case of NF in a patient with undiagnosed diabetes mellitus and severe obesity due to infection with two types of Lactobacillus spp. that manifested in extensive necrosis. Case presentation A 48-year-old woman was referred to our hospital with a complaint of difficulty in walking due to severe bilateral thigh pain. She presented with pale redness, swelling, and severe skin pain extending from the pubic region to the groin. The patient was morbidly obese, had renal dysfunction and had not been diagnosed having diabetes mellitus; her LRINEC (Laboratory Risk Indicator for Necrotising Fasciitis) score was 9, indicating a high risk of NF. An exploratory surgical incision was made and NF was diagnosed based on fascial necrosis. Emergent surgical debridement was performed, and cultures of the wound and abscess revealed two types of Lactobacillus spp.: Lactobacillus salivariusand L. iners. The patient was admitted to the intensive care unit (ICU), where antibiotics were administered and respiratory and circulatory managements were performed. Diabetic ketoacidosis was detected, which was treated by controlling the blood glucose level stringently via intravenous insulin infusion. The patient underwent a second debridement on day 11 and, skin suture and skin grafting on day 36. The patient progressed well, was transferred from the ICU to the general ward on day 41, and was discharged unassisted on day 73. Conclusions Lactobacillus spp. are rarely pathogenic to healthy individuals and can seldom trigger NF. However, these bacteria can cause rare infections such as NF in immunocompromised individuals, such as those with diabetes and obesity, and an early diagnosis of NF is imperative; surgical intervention may be required for prevention of extensive necrosis. The LRNEC score may be useful for the early diagnosis of NF even for less pathogenic bacteria such as the Lactobacillus.

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“…Its occurrence is rare, with approximately 4 per 100,000 people per year, with the condition being most frequently diagnosed in individuals between 50 and 60 years of age, with a higher prevalence in men [ 2 ]. Risk factors include diabetes, immunosuppression, malnutrition, advanced age, non-steroidal anti-inflammatory drug (NSAID) use, morbid obesity, liver cirrhosis, alcoholism, chronic renal failure, HIV/AIDS, and underlying malignancy [ 3 ]. Notably, patients with diabetes and obese individuals account for 22–59% and 17–31% of all cases, respectively.…”

Section: Introductionmentioning

confidence: 99%

Necrotising fasciitis with extensive necrosis caused by Lactobacillus: a case report

Nagayama,

Sato,

Takanori

et al. 2024

BMC Infect Dis

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Background Necrotising fasciitis (NF) is a life-threatening soft-tissue infection that rapidly destroys the epidermis, subcutaneous tissue, and fascia. Despite their low virulence, Lactobacillus spp. can cause NF, and because of its rare incidence, there is limited information about its molecular and clinicopathological characteristics. We report a rare case of NF in a patient with type 2 diabetes mellitus diagnosed on admission and severe obesity due to infection with two types of Lactobacillus spp. that manifested in extensive necrosis. Case presentation A 48-year-old woman was referred to our hospital with a complaint of difficulty walking due to severe bilateral thigh pain. She presented with mild erythema, swelling, and severe skin pain extending from the pubic region to the groin. The patient was morbidly obese, had renal dysfunction, and had diabetes mellitus diagnosed on admission.; her LRINEC (Laboratory Risk Indicator for Necrotising Fasciitis) score was 9, indicating a high risk of NF. An exploratory surgical incision was made, and NF was diagnosed based on fascial necrosis. Emergent surgical debridement was performed, and cultures of the tissue culture and aspirated fluid/pus revealed two types of Lactobacillus spp.: Lactobacillus salivarius and L. iners. The patient was admitted to the intensive care unit (ICU), where antibiotics were administered and respiratory and circulatory management was performed. Diabetic ketoacidosis was detected, which was treated by controlling the blood glucose level stringently via intravenous insulin infusion. The patient underwent a second debridement on day 11 and a skin suture and skin grafting on day 36. The patient progressed well, was transferred from the ICU to the general ward on day 41, and was discharged unassisted on day 73. Conclusions Lactobacillus spp. are rarely pathogenic to healthy individuals and can scarcely trigger NF. However, these bacteria can cause rare infections such as NF in immunocompromised individuals, such as those with diabetes and obesity, and an early diagnosis of NF is imperative; surgical intervention may be required for the prevention of extensive necrosis. The LRINEC score may be useful for the early diagnosis of NF, even for less pathogenic bacteria such as Lactobacillus.

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Necrotizing fasciitis – a review

Cited by 17 publications

References 39 publications

Cervical Necrotizing Fasciitis: a life-threatening emergency in Oral and Maxillofacial Surgery

Cervical Necrotizing Fasciitis: a life-threatening emergency in Oral and Maxillofacial Surgery

Necrotising fasciitis with extensive necrosis caused by Lactobacillus: A case report

Necrotising fasciitis with extensive necrosis caused by Lactobacillus: a case report

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