Necrotizing fasciitis classification: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Necrotizing fasciitis}} | {{Necrotizing fasciitis}} | ||
{{ | {{CMG}}; {{AE}}{{YK}} | ||
==Overview== | |||
Necrotizing fasciitis may be classified according to International Classification of Diseases-10 ([[ICD-10]]) into M72.6 Necrotizing fasciitis.<ref name="ICD10">ICD-10 version:2016. http://apps.who.int/classifications/icd10/browse/2016/en#/M72.6 2016 Accessed on August 25,2016 </ref> 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.<ref name="pmid22491537">{{cite journal| author=Lancerotto L, Tocco I, Salmaso R, Vindigni V, Bassetto F| title=Necrotizing fasciitis: classification, diagnosis, and management. | journal=J Trauma Acute Care Surg | year= 2012 | volume= 72 | issue= 3 | pages= 560-6 | pmid=22491537 | doi=10.1097/TA.0b013e318232a6b3 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22491537 }} </ref> | |||
==Classification== | |||
Based on microbiological findings, necrotizing fasciitis may be classified into four types.<ref name="pmid20542593">{{cite journal| author=Morgan MS| title=Diagnosis and management of necrotising fasciitis: a multiparametric approach. | journal=J Hosp Infect | year= 2010 | volume= 75 | issue= 4 | pages= 249-57 | pmid=20542593 | doi=10.1016/j.jhin.2010.01.028 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20542593 }} </ref><ref name="pmid327844">{{cite journal| author=Giuliano A, Lewis F, Hadley K, Blaisdell FW| title=Bacteriology of necrotizing fasciitis. | journal=Am J Surg | year= 1977 | volume= 134 | issue= 1 | pages= 52-7 | pmid=327844 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=327844 }} </ref><ref name="pmid14707592">{{cite journal| author=Goodell KH, Jordan MR, Graham R, Cassidy C, Nasraway SA| title=Rapidly advancing necrotizing fasciitis caused by Photobacterium (Vibrio) damsela: a hyperaggressive variant. | journal=Crit Care Med | year= 2004 | volume= 32 | issue= 1 | pages= 278-81 | pmid=14707592 | doi=10.1097/01.CCM.0000104920.01254.82 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=14707592 }} </ref><ref name="pmid18687029">{{cite journal| author=Monaghan SF, Anjaria D, Mohr A, Livingston DH| title=Necrotizing fasciitis and sepsis caused by Aeromonas hydrophila after crush injury of the lower extremity. | journal=Surg Infect (Larchmt) | year= 2008 | volume= 9 | issue= 4 | pages= 459-67 | pmid=18687029 | doi=10.1089/sur.2007.028 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18687029 }} </ref><ref name="pmid16741524">{{cite journal| author=Jain D, Kumar Y, Vasishta RK, Rajesh L, Pattari SK, Chakrabarti A| title=Zygomycotic necrotizing fasciitis in immunocompetent patients: a series of 18 cases. | journal=Mod Pathol | year= 2006 | volume= 19 | issue= 9 | pages= 1221-6 | pmid=16741524 | doi=10.1038/modpathol.3800639 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16741524 }} </ref><ref name="pmid8969999">{{cite journal| author=Quirk WF, Sternbach G| title=Joseph Jones: infection with flesh eating bacteria. | journal=J Emerg Med | year= 1996 | volume= 14 | issue= 6 | pages= 747-53 | pmid=8969999 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8969999 }} </ref><ref name="pmid16643131">{{cite journal| author=Kihiczak GG, Schwartz RA, Kapila R| title=Necrotizing fasciitis: a deadly infection. | journal=J Eur Acad Dermatol Venereol | year= 2006 | volume= 20 | issue= 4 | pages= 365-9 | pmid=16643131 | doi=10.1111/j.1468-3083.2006.01487.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16643131 }} </ref> | |||
{| class="wikitable" style="text-align:left" | |||
|- | |||
! Type !! Organism | |||
|- | |||
| Type 1 (70%-80% cases) <br>Polymicrobial/[[Synergistic]] || ● Mixed aerobes and anaerobes <br> ● Often bowel flora-derived | |||
|- | |||
| Type 2 (20% to 30% cases) <br>Monomicrobial || ● [[Streptococci|Beta-Hemolytic Streptococci group A]] ([[Streptococcus pyogenes]]) <br> ● with/without ''[[Staphylococcus aureus]]'' <br> ● Skin or throat derived | |||
|- style="vertical-align:top;" | |||
| Type 3 (common in Asia) <br>Gram negative monomicrobial NF (including marine related organisms)|| ● [[Vibrio|Vibrio spp]] mainly | |||
|- | |||
| Type 4 <br>[[Fungal]] || ● [[Candida]] ([[Immunocompromised]] patients) <br>● [[Zygomycetes]] ([[Immunocompetent]] patients) | |||
|} | |||
*Based on anatomic location, necrotizing fasciitis may be classified into:<ref name="pmid22491537">{{cite journal| author=Lancerotto L, Tocco I, Salmaso R, Vindigni V, Bassetto F| title=Necrotizing fasciitis: classification, diagnosis, and management. | journal=J Trauma Acute Care Surg | year= 2012 | volume= 72 | issue= 3 | pages= 560-6 | pmid=22491537 | doi=10.1097/TA.0b013e318232a6b3 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22491537 }} </ref> | |||
:*[[Fournier's gangrene]] (necrotizing fasciitis of perineum) | |||
:*Craniofascial necrotizing fasciitis | |||
:*Cervical fasciitis | |||
:*[[Ludwig's angina]] (submandibular and sublingual spaces)<ref name="pmid16696873">{{cite journal| author=Wasson J, Hopkins C, Bowdler D| title=Did Ludwig's angina kill Ludwig? | journal=J Laryngol Otol | year= 2006 | volume= 120 | issue= 5 | pages= 363-5 | pmid=16696873 | doi=10.1017/S0022215106000806 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16696873 }} </ref> | |||
*Based on severity of disease, necrotizing fasciitis is classified into:<ref name="pmid15735411">{{cite journal| author=Wong CH, Wang YS| title=The diagnosis of necrotizing fasciitis. | journal=Curr Opin Infect Dis | year= 2005 | volume= 18 | issue= 2 | pages= 101-6 | pmid=15735411 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15735411 }} </ref> | |||
:*Hyperacute | |||
:*Sub-acute | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
[[Category:Emergency mdicine]] | |||
[[Category:Disease]] | [[Category:Disease]] | ||
[[Category:Up-To-Date]] | |||
[[Category:Infectious disease]] | [[Category:Infectious disease]] | ||
[[Category:Surgery]] | |||
[[Category:Orthopedics]] |
Latest revision as of 22:56, 29 July 2020
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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]
- Fournier's gangrene (necrotizing fasciitis of perineum)
- Craniofascial necrotizing fasciitis
- Cervical fasciitis
- Ludwig's angina (submandibular and sublingual spaces)[10]
- Based on severity of disease, necrotizing fasciitis is classified into:[11]
- Hyperacute
- Sub-acute
References
- ↑ ICD-10 version:2016. http://apps.who.int/classifications/icd10/browse/2016/en#/M72.6 2016 Accessed on August 25,2016
- ↑ 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.
- ↑ 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.
- ↑ Giuliano A, Lewis F, Hadley K, Blaisdell FW (1977). "Bacteriology of necrotizing fasciitis". Am J Surg. 134 (1): 52–7. PMID 327844.
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ Quirk WF, Sternbach G (1996). "Joseph Jones: infection with flesh eating bacteria". J Emerg Med. 14 (6): 747–53. PMID 8969999.
- ↑ 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.
- ↑ 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.
- ↑ Wong CH, Wang YS (2005). "The diagnosis of necrotizing fasciitis". Curr Opin Infect Dis. 18 (2): 101–6. PMID 15735411.