Nekrotisierende Fasziitis

Jansen-Winkeln, Boris; Langer, Stefan; Minh, Hoang; Gockel, Ines

doi:10.1007/s00104-019-01108-3

Cited by 4 publications

(6 citation statements)

References 28 publications

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“…Jansen-Winkeln et al 3 found the diagnosis of NSTI primarily clinical and that a regimen of clindamycin, gentamicin, and penicillin provides satisfactory coverage against 95% of causative pathogens. Young et al outlined the pathogenesis and treatment of NSTI.…”

Section: Discussionmentioning

confidence: 99%

“…2 The diagnosis of this infection remains clinical, and the key to successful intervention is rapid surgical debridement with appropriate broad-spectrum antibiotic therapy. 3 Broad-spectrum antibiotic therapy is crucial in combating this disease and avoiding mortality and morbidity in patients. We hope to elucidate the effect on patient outcomes with the use of clindamycin in the initial antibiotic regimen in treating NSTI.…”

Section: Introductionmentioning

confidence: 99%

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Use of Clindamycin for Necrotizing Soft Tissue Infection Decreases Amputation Rate

Heath

Boyer

Ghali

et al. 2022

Journal of Orthopaedic Trauma

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Objective:To identify the impact of clindamycin use on mortality and amputation rates in patients with necrotizing fasciitis.Design:Retrospective review.Setting:Level 1 trauma center, single-center study.Patients/Participants:All patients from 2008 to 2019 with a diagnosis of necrotizing fasciitis. One hundred ninety patients were included in statistical analysis.Intervention:Use of clindamycin in the initial antibiotic regimen in the treatment of necrotizing soft tissue infection.Main Outcome Measurements:Amputation and mortality rates.Results:Patients who received clindamycin had 2.92 times reduced odds of having an amputation when compared with their counterparts, even when American Society of Anesthesiologist scores, comorbidities, smoking, drug use, alcohol consumption, race, ethnicity, sex, and age were controlled for and regardless of other antibiotics started (P = 0.015). There was no significant difference in mortality rate between those patients who did and did not receive clindamycin as part of their initial antibiotic regimen (8.3% vs. 11.6%, respectively; P = 0.453).Conclusion:The use of clindamycin in the initial antibiotic regimen for treatment of NSTI was shown to significantly decrease rates of amputation but not mortality.Level of Evidence:Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Use of Clindamycin for Necrotizing Soft Tissue Infection Decreases Amputation Rate

Heath

Boyer

Ghali

et al. 2022

Journal of Orthopaedic Trauma

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“…The processes of fasciitis with induration, collection, erythema, pain, crackles have been obviously identified, usually at 3-4 days and only where aggressive and early intervention could be mastered ( 2 ). A characteristic frequently present in this pathology is represented by the discrepancy between the apparently minimal visible skin damage and the noisy systemic symptoms ( 28 ).…”

Section: Discussionmentioning

confidence: 99%

Necrotizing fasciitis of the chest wall: A clinical case report and literature review

Petreanu¹,

Constantin

Iosifescu

et al. 2021

Exp Ther Med

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Necrotizing fasciitis of the chest wall is a very rare pathology, but with significant mortality, representing a therapeutic challenge. All international reports indicate the need for early diagnosis and an aggressive medical-surgical attitude in order to improve the prognosis. In addition to a review of literature, we present a case developed secondary to a thoracic pleural drainage for pyopneumothorax associated with significant bronchopleural fistula in a destroyed tuberculous left lung. Along with medical treatment, extensive surgical debridement was required. Despite drainage incisions and negative pressure wound therapy (NPWT), the evolution of the fasciitis was difficult, due to bronchopleurocutaneous fistula. Thus, the Azorin procedure (transcervical mediastinoscopic closure of the left main bronchus) was performed. Once this procedure was completed, the inflammatory phenomena were controlled which allowed for a second step consisting of left pneumonectomy, with the application of specific methods for the prevention of bronchial fistula. The clinical case was a therapeutic challenge requiring a complex, staged, multidisciplinary approach due to both the immunocompromised terrain and the severity of the lesions. In conclusion, early recognition and aggressive and combined application of medical and surgical treatment methods can ensure therapeutic success.

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“…The incidence of NF is estimated to be 0.4 to 1.69 cases per 100,000 population with increasing incidence [3][4][5]. As a destructive soft tissue infection, it can affect all parts of the body.…”

Section: Introductionmentioning

confidence: 99%

Occupational Hazard: A Case of Type II Necrotizing Fasciitis in a Medical Professional

Neudeck,

Keppler,

Böcker

et al. 2024

Preprint

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Background Necrotizing Fasciitis (NF) is a rapidly progressing infectious disease with a high mortality rate. It affects the soft tissue involving the fascia and subcutaneous tissue. In the case of thoracic, NF is associated with a significantly higher lethality. Group A streptococci are the most common pathogens of this infection. Early diagnosis, rapid and radical surgical therapy and antibiotic treatment are crucial for a successful outcome. Case presentation: This report outlines a case of a medical professional in his mid-60s, who developed NF in his right arm and hemithorax, likely contracted from a patient he treated. He presented himself at our clinic with chest pain, general weakness and a moderate fever. In addition, he had clear signs of infection and an inflamed, swollen area on the right chest wall. Despite the severity of the infection, quick recognition, immediate surgical intervention and intensive care management resulted in a successful outcome. Gene sequencing confirmed a match of the superantigens and the serotype emm1.0 of the streptococcus pyogenes with those of the patient he had treated shortly before. Conclusion This case emphasizes the critical role of early detection, rapid surgical debridement and broad-spectrum antibiotic therapy in managing NF. It also underlines the occupational risks faced by healthcare workers, highlighting the importance of strict adherence to infection control protocols. The report aims to raise awareness of NF, advocating for its consideration when patients present systemic infection signs, particularly in emergency departments.

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Nekrotisierende Fasziitis

Cited by 4 publications

References 28 publications

Use of Clindamycin for Necrotizing Soft Tissue Infection Decreases Amputation Rate

Use of Clindamycin for Necrotizing Soft Tissue Infection Decreases Amputation Rate

Necrotizing fasciitis of the chest wall: A clinical case report and literature review

Occupational Hazard: A Case of Type II Necrotizing Fasciitis in a Medical Professional

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