Necrotizing Soft Tissue Infection - An Increasing Problem in Orthopedic Trauma

Abstract

In a trauma hospital 5 patients with necrotizing fasciitis were observed during the last 7 years. The causative agent was streptococci B in 1 patient, streptococci A in 3 patients, and staphylococci in 1 patient. Three patients developed a toxic shock syndrome, which was fatal in 2. One patient was treated for a gout arthritis with intramuscular injection of NSAID, 2 patients were treated for fractures, and 2 for soft tissue injuries. Potential risk factors for a necrotizing soft tissue inflammation was a metabolic syndrome plus chronic nasopharyngeal infections in 1 patient, obesity in 1, and an occult myeloic leukemia in 1 patient. The problem of necrotizing fasciitis in trauma patients is not new, but own observations and the literature suggest an increasing frequency of this disease over the last decade. Necrotizing fasciitis can be encountered unexpectedly in any given situation, early diagnosis which can be very difficult is the clue to successful treatment.

Post-traumatic occipital psoriatic plaque complicated by extensive necrotizing fasciitis of the head and neck: a case report and literature review

“… 8 , 9 In patients with improper surgical management of NF, death is induced by progressive organ failure. 10 The etiology of NF varies in the literature; reported causes include dento-periodontal foci 11 associated or unassociated with diabetes mellitus, intravenous drug use and abuse, 12 trauma compromising the skin barrier, 13 , 14 and postoperative complications or even idiopathic causes. 4 , 15 Regardless of the causal factor, any type of infection is likely to be worsened by alcoholism, diabetes mellitus, renal failure, malignancy, immunological deficiencies, nutritional disorders such as obesity, increased age, and even metabolic syndrome in young adults.…”