Necrotizing fasciitis secondary to diverticulitis

Piedra, Tatiana; Martín-Cuesta, Laura; Arnáiz, Javier; Lucas, Enrique Marco de; Pellón, Raúl; García-Bolado, Ana; González, Francisco José

doi:10.1007/s10140-006-0566-9

Cited by 17 publications

(5 citation statements)

References 10 publications

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“…In addition to malignancy, enterocolitis has also been identified as a risk factor for the development of gas gangrene [11] , [12] , [13] . It has been demonstrated that gastrointestinal inflammation causes hypoxia [14] , and it may be the hypoxic environment that helps propagates spore formation and the spread of infection.…”

Section: Discussionmentioning

confidence: 99%

Massive gas gangrene secondary to occult colon carcinoma

Griffin

Crawford

Gupta

2016

Radiology Case Reports

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Gas gangrene is a rare but often fatal soft-tissue infection. Because it is uncommon and the classic symptom of crepitus does not appear until the infection is advanced, prompt diagnosis requires a high index of suspicion. We present a case report of a middle-aged man who presented with acute onset lower-extremity pain that was initially thought to be due to deep vein thrombosis. After undergoing workup for pulmonary embolism, he was found to have massive gas gangrene of the lower extremity secondary to an occult colon adenocarcinoma and died within hours of presentation from multisystem organ failure.

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Section: Discussionmentioning

confidence: 99%

Massive gas gangrene secondary to occult colon carcinoma

Griffin

Crawford

Gupta

2016

Radiology Case Reports

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“…Diabetes mellitus and peripheral vascular disease are common predisposing factors in poly-microbial NSTI [32]. Other predisposing factors include obesity, chronic renal failure, human immunodeficiency virus (HIV) infection, alcohol abuse, abscess, intravenous (IV) drug use, insect bites, recent surgical incisions, and perforation of the gastrointestinal tract [29,33,34]. Interestingly, an inciting event is never identified in 20%-50% of the patients [14,15,35].…”

Section: Microbiologymentioning

confidence: 99%

Management and Novel Adjuncts of Necrotizing Soft Tissue Infections

Cocanour

Chang

Huston

et al. 2017

Surgical Infections

116

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Necrotizing soft tissue infections (NSTI) have been recognized for millennia and continue to impose considerable burden on both patient and society in terms of morbidity, death, and the allocation of resources. With improvements in the delivery of critical care, outcomes have improved, although disease-specific therapies are lacking. The basic principles of early diagnosis, of prompt and broad antimicrobial therapy, and of aggressive debridement have remained unchanged. Clearly novel and new therapeutics are needed to combat this persistently lethal disease. This review emphasizes the pillars of NSTI management and then summarizes the contemporary evidence supporting the incorporation of novel adjuncts to the pharmacologic and operative foundations of managing this disease.

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“…Nonetheless, the epidemiology of type I NSTIs seems to indicate that the major pathophysiologic factor in development of such an infection is on overall state of poor health or immunocompromise. Thus, these polymicrobial NSTIs of the trunk, perineum, or neck are associated with diabetes and peripheral vascular disease, 10 obesity, chronic renal insufficiency, alcohol abuse, existing abscesses, [21][22][23][24] blunt trauma, chicken pox, HIV or AIDS, and, as mentioned above, IV drug abuse. 2…”

Section: Pathophysiologymentioning

confidence: 99%

Necrotizing Soft Tissue Infections

Shiroff

Herlitz

Gracias

2012

J Intensive Care Med

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Necrotising soft tissue infection (NSTI) presents unique challenges in diagnosis and management. The key to a successful outcome is a high index of suspicion in appropriate clinical settings. Type II NSTI tends to occur on an extremity in younger, healthier patients with a history of known trauma, and to be monomicrobial. Type I NSTI tends to occur on the trunk of older, less healthy patients without an obvious history of trauma, and tends to be polymicrobial. Other, rarer types exist as well. The pathophysiology of both types involves superantigen acticivty, as well as a number of microbial byproducts which collectively decrease the viscosity of pus, facilitating its spread along deep tissue planes and ultimately causing diffuse deep thrombosis and aggressive systemic sepsis. The most important physical finding is tenderness to palpation beyond the area of redness, and the lack of crepitus should not be seen as a reassuring sign. Suspected cases should undergo early surgical exploration for diagnosis, which may be performed at bedside through a small incision. Most imaging techniques are not sufficiently specific to warrant a delay in surgical exploration. The Laboratory Risk Indicator for Necrotising Fasciitis (LRINEC) shows promise as a tool for excluding suspected cases. Successful outcomes in cases of NSTI require early and aggressive serial debridement and a multidisciplinary critical care approach.

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Necrotizing fasciitis secondary to diverticulitis

Cited by 17 publications

References 10 publications

Massive gas gangrene secondary to occult colon carcinoma

Massive gas gangrene secondary to occult colon carcinoma

Management and Novel Adjuncts of Necrotizing Soft Tissue Infections

Necrotizing Soft Tissue Infections

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