Necrotizing fasciitis classification

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Yamuna Kondapally, M.B.B.S[2]

Overview

Necrotizing fasciitis may be classified according to International Classification of Diseases-10 (ICD-10) into M72.6 Necrotizing fasciitis.[1] Based on microbiological findings, necrotizing fasciitis may be classified into four types: Type I, Type II, Type III, and Type IV. Necrotizing fasciitis is further classified based on anatomic location and severity of symptoms.[2]

Classification

Based on microbiological findings, necrotizing fasciitis may be classified into four types.[3][4][5][6][7][8][9]

Type Organism
Type 1 (70%-80% cases)
Polymicrobial/Synergistic
● Mixed aerobes and anaerobes
● Often bowel flora-derived
Type 2 (20% to 30% cases)
Monomicrobial
Beta-Hemolytic Streptococci group A (Streptococcus pyogenes)
● with/without Staphylococcus aureus
● Skin or throat derived
Type 3 (common in Asia)
Gram negative monomicrobial NF (including marine related organisms)
Vibrio spp mainly
Type 4
Fungal
Candida (Immunocompromised patients)
Zygomycetes (Immunocompetent patients)
  • Based on anatomic location, necrotizing fasciitis may be classified into:[2]
  • Based on severity of disease, necrotizing fasciitis is classified into:[11]
  • Hyperacute
  • Sub-acute

References

  1. ICD-10 version:2016. http://apps.who.int/classifications/icd10/browse/2016/en#/M72.6 2016 Accessed on August 25,2016
  2. 2.0 2.1 Lancerotto L, Tocco I, Salmaso R, Vindigni V, Bassetto F (2012). "Necrotizing fasciitis: classification, diagnosis, and management". J Trauma Acute Care Surg. 72 (3): 560–6. doi:10.1097/TA.0b013e318232a6b3. PMID 22491537.
  3. Morgan MS (2010). "Diagnosis and management of necrotising fasciitis: a multiparametric approach". J Hosp Infect. 75 (4): 249–57. doi:10.1016/j.jhin.2010.01.028. PMID 20542593.
  4. Giuliano A, Lewis F, Hadley K, Blaisdell FW (1977). "Bacteriology of necrotizing fasciitis". Am J Surg. 134 (1): 52–7. PMID 327844.
  5. Goodell KH, Jordan MR, Graham R, Cassidy C, Nasraway SA (2004). "Rapidly advancing necrotizing fasciitis caused by Photobacterium (Vibrio) damsela: a hyperaggressive variant". Crit Care Med. 32 (1): 278–81. doi:10.1097/01.CCM.0000104920.01254.82. PMID 14707592.
  6. Monaghan SF, Anjaria D, Mohr A, Livingston DH (2008). "Necrotizing fasciitis and sepsis caused by Aeromonas hydrophila after crush injury of the lower extremity". Surg Infect (Larchmt). 9 (4): 459–67. doi:10.1089/sur.2007.028. PMID 18687029.
  7. Jain D, Kumar Y, Vasishta RK, Rajesh L, Pattari SK, Chakrabarti A (2006). "Zygomycotic necrotizing fasciitis in immunocompetent patients: a series of 18 cases". Mod Pathol. 19 (9): 1221–6. doi:10.1038/modpathol.3800639. PMID 16741524.
  8. Quirk WF, Sternbach G (1996). "Joseph Jones: infection with flesh eating bacteria". J Emerg Med. 14 (6): 747–53. PMID 8969999.
  9. Kihiczak GG, Schwartz RA, Kapila R (2006). "Necrotizing fasciitis: a deadly infection". J Eur Acad Dermatol Venereol. 20 (4): 365–9. doi:10.1111/j.1468-3083.2006.01487.x. PMID 16643131.
  10. Wasson J, Hopkins C, Bowdler D (2006). "Did Ludwig's angina kill Ludwig?". J Laryngol Otol. 120 (5): 363–5. doi:10.1017/S0022215106000806. PMID 16696873.
  11. Wong CH, Wang YS (2005). "The diagnosis of necrotizing fasciitis". Curr Opin Infect Dis. 18 (2): 101–6. PMID 15735411.

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