Necrotizing fasciitis natural history, complications and prognosis: Difference between revisions
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==Complications== | ==Complications== | ||
Common complications of necrotizing fasciitis include:<ref>necrotizing soft tissue infection https://medlineplus.gov/ency/article/001443.htm (2016) Accessed on september 6, 2016 </ref> | |||
*Limb loss | |||
*Sepsis | |||
*Kidney failure | |||
*Extensive scarring and disfigurement | |||
*Toxic shock syndrome | |||
*Rapid advancement of disease resulting in death | |||
====Type 2 NF and streptococcal toxic shock syndrome==== | ====Type 2 NF and streptococcal toxic shock syndrome==== | ||
*Most of Type 2 NF cases are associated with | *Most of Type 2 NF cases are associated with streptococcal toxic shock syndrome which increases the mortality of streptococcal NF alone from <40% to 67% with up to half of patients needing amputation. | ||
*The superantigens cause massive activation of t-cell, cytokine release, tissue damage and toxic shock-like syndrome | *The superantigens cause massive activation of t-cell, cytokine release, tissue damage and toxic shock-like syndrome | ||
Revision as of 15:34, 6 September 2016
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
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Overview
Natural History
- If left untreated, the acute inflammatory changes spread quickly, accompanied by high fever and extreme weakness.
- The overlying skin becomes smooth, tense and shiny. Diffuse erythema without distinct borders is seen.
- First 1 or 2 days, the lesions develop with progressive colour changes from red to purple to blue and then becomes frankly gangrenous, first turning black, then greenish yellow.
- If the patient has survived, a line of demarcation between viable and necrotic tissue would become sharply defined from days 7 to 10.
- Sloughing of necrotic skin would reveal the underlying pus and extensive liquefaction necrosis of subcutaneous tissues, which will be significantly more extensive than would be suspected with the overlying area of necrotic skin.
- Metastatic abscesses and pulmonary distress may develop as well.
Complications
Common complications of necrotizing fasciitis include:[1]
- Limb loss
- Sepsis
- Kidney failure
- Extensive scarring and disfigurement
- Toxic shock syndrome
- Rapid advancement of disease resulting in death
Type 2 NF and streptococcal toxic shock syndrome
- Most of Type 2 NF cases are associated with streptococcal toxic shock syndrome which increases the mortality of streptococcal NF alone from <40% to 67% with up to half of patients needing amputation.
- The superantigens cause massive activation of t-cell, cytokine release, tissue damage and toxic shock-like syndrome
Prognosis
This disease is one of the fastest-spreading infections known, as it spreads easily across the fascial plane within the subcutaneous tissue. For this reason, it is popularly called the “flesh-eating disease,” and, although rare, it became well-known to the public in the 1990s. Even with today's modern medicine, the prognosis can be bleak, with a mortality rate of approximately 25% and severe disfigurement common in survivors.
References
- ↑ necrotizing soft tissue infection https://medlineplus.gov/ency/article/001443.htm (2016) Accessed on september 6, 2016