Necrotizing fasciitis in neonates

Abstract

Necrotizing fasciitis (NF) is a potentially life-threatening infection of soft tissues. It is characterized by rapid spread of inflammation and infection with widespread necrosis of fascia, subcutaneous tissues, and overlying skin. NF is usually reported in adults with preexisting medical conditions or compromised immune system. It is rare in neonates, and the reported mortality is close to 50% in this population. Less than 70 cases of neonatal NF are reported in literature, most in otherwise healthy neonates and usually attributed to omphalitis, mastitis, or postoperative wound infections. We report our experience of nine neonates who developed NF spontaneously (primary NF) and look at the etiology, clinical presentation, microbiology, management, and outcome.

Neonatal Mastitis After Breast Massage: A Case Report

“…Ayrıca nekrotizan fasiit, beyin apsesi, osteomiyelit ve sepsis gibi ciddi süpüratif komplikasyonlar akut dönemde gelişebilirken, özellikle kızlar-da meme dokusunu gelişimi uzun dönemde olumsuz etkilenebilir ve erişkin yaşta kozmetik sorunlarla karşılaşılabilir (9)(10)(11) . Olgumuzda akut dönemde herhangi bir komplikasyon gözlenmedi.…”

Necrotizing Fasciitis in a Neonate – The Role of Keratinocyte Allografts

“…Adult NF is mainly associated with underlying diseases like diabetes, metastatic carcinoma, chronic renal failure and other immune-compromised conditions, whereas most children who develop NF are healthy [2] . In newborns, omphalitis, circumcision, postoperative complications, venipuncture and misplacement of electrodes placed to monitor vital signs have been reported to initiate NF [2,5] .…”

“…Ultrasonography, CT and magnetic resonance imaging have been reported to be helpful in terms of early diagnosis and estimating disease extent [2] . The sonographic features of NF include fascial thickening with fluid accumulation, turbid fluid or a loculated abscess in the fascial plane, and subcutaneous tissue swelling.…”

“…In newborns, omphalitis, circumcision, postoperative complications, venipuncture and misplacement of electrodes placed to monitor vital signs have been reported to initiate NF [2,5] . In our patient, the incision and draining of pustules at home were believed to have initiated NF.…”

“…It is a predominantly adult disorder and is uncommon in children, but is rare in neonates [2] . Broad-spectrum antibiotics and aggressive surgical debridement remains the mainstay of treatment, but sometimes the coverage of large wounds is problematic.…”