Necrotizing fasciitis: Difference between revisions

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'''For patient information on this page, click [[Necrotizing fasciitis (patient information)|here]]'''  
'''For patient information on this page, click [[Necrotizing fasciitis (patient information)|here]]'''  


{{CMG}}; {{AE}} {{YK}} {{CZ}}
{{CMG}}; {{AE}} {{YK}}, {{CZ}}


{{SK}}Phagadena; Phagadena gangrenosum; Meleney’s gangrene; Hemolytic streptococcal gangrene; Flesh eating bacteria; Hospital gangrene; Acute dermal gangrene; Suppurative fasciitis; Synergistic necrotizing cellulitis; Gangrenous ulcer; Malignant ulcer; Putrid ulcer
{{SK}}NF; Phagadena; Phagadena gangrenosum; Meleney’s gangrene; Hemolytic streptococcal gangrene; Flesh eating bacteria; Hospital gangrene; Acute dermal gangrene; Suppurative fasciitis; Synergistic necrotizing cellulitis; Gangrenous ulcer; Malignant ulcer; Putrid ulcer; Necrotizing erysipelas; Nonclostridial gas gangrene; Bacterial synergistic gangrene


==[[Necrotizing fasciitis overview|Overview]]==
==[[Necrotizing fasciitis overview|Overview]]==


==[[Necrotizing fasciitis historical perspective|Historical Perspective]]==
==[[Necrotizing fasciitis historical perspective|Historical Perspective]]==
*Necrotizing fasciitis was first described by Hippocrates in the fifth century B.C. as the complication of [[erysipelas]]<ref name="pmid556077">{{cite journal| author=Wasfy AA, Shoeb S, El-Mashad A, El-Ebrashy N, Higazi A, Gaber A et al.| title=Detection of anaerobic respiratory bacteria with a new therapeutic approach. | journal=J Egypt Med Assoc | year= 1978 | volume= 61 | issue= 11-12 | pages= 757-61 | pmid=556077 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=556077  }} </ref><ref name="pmid1988793">{{cite journal| author=Caplehorn JR, Bell J| title=Methadone dosage and retention of patients in maintenance treatment. | journal=Med J Aust | year= 1991 | volume= 154 | issue= 3 | pages= 195-9 | pmid=1988793 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1988793  }} </ref>
*It was first described as "Hospital gangrene" during civil war by confederate army surgeon Joseph Jones.
*The association between bacterial infection and necrotizing fasciitis was made in 1918.
*In 1952, the disease was named as necrotizing fasciitis.


==[[Necrotizing fasciitis classification|Classification]]==
==[[Necrotizing fasciitis classification|Classification]]==
*Necrotizing fasciitis may be classified according to international classification of diseases-10 (ICD-10) into:<ref> ICD-10 version:2016. http://apps.who.int/classifications/icd10/browse/2016/en#/M72.6 2016 Accessed on August 25,2016 </ref>
:*M72.6 Necrotizing fasciitis
*Based on microbiological findings, necrotizing fasciitis may be classified into four types
{| class="wikitable" style="text-align:left"
|-
! Type !! Organism
|-
| Type 1 or Polymicrobial || ● ''[[Non-Group A streptococci]]''<br>● Anaerobes including clostridia<br>● Facultative anaerobes<br>● Enterobacteria             
|-
| Type 2 or Monomicrobial || ● Beta hemolytic streptococcus group A ([[Streptococcus pyogenes]])
|-
| Type 3 or<br> Gas gangrene or<br> Clostridial myonecrosis|| ● Marine [[vibrio vulnificus]]
|-
| Type 4 || ● [[MRSA]]
|}


==[[Necrotizing fasciitis pathophysiology|Pathophysiology]]==
==[[Necrotizing fasciitis pathophysiology|Pathophysiology]]==
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==[[Necrotizing fasciitis epidemiology and demographics|Epidemiology and Demographics]]==
==[[Necrotizing fasciitis epidemiology and demographics|Epidemiology and Demographics]]==
===Prevalence===
===Incidence===
*The incidence of necrotizing fasciitis in adults is 0.40 cases per 100,000 people/year and the incidence in children is higher at 0.08 cases per 100,000 people/year.<ref name="pmid9599907">{{cite journal| author=File TM, Tan JS, DiPersio JR| title=Group A streptococcal necrotizing fasciitis. Diagnosing and treating the "flesh-eating bacteria syndrome". | journal=Cleve Clin J Med | year= 1998 | volume= 65 | issue= 5 | pages= 241-9 | pmid=9599907 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9599907  }} </ref><ref name="pmid3051309">{{cite journal| author=Chaouat Y, Chaouat D| title=[Primary hyperparathyroidism. History]. | journal=Rev Rhum Mal Osteoartic | year= 1988 | volume= 55 | issue= 7 | pages= 475-8 | pmid=3051309 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3051309  }} </ref>
*
===Case Fatality Rate===
===Age===
===Gender===
===Race===
===Developed countries===
===Developing countries===


==[[Necrotizing fasciitis risk factors|Risk Factors]]==
==[[Necrotizing fasciitis risk factors|Risk Factors]]==
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==Diagnosis==
==Diagnosis==
[[Necrotizing fasciitis history and symptoms|History and Symptoms]] | [[Necrotizing fasciitis physical examination|Physical Examination]] | [[Necrotizing fasciitis laboratory findings|Laboratory Findings]] | [[Necrotizing fasciitis electrocardiogram|Electrocardiogram]] | [[Necrotizing fasciitis x ray|X Ray]] | [[Necrotizing fasciitis CT|CT]] | [[Necrotizing fasciitis MRI|MRI]] | [[Necrotizing fasciitis ultrasound|Ultrasound]] | [[Necrotizing fasciitis other imaging findings|Other Imaging Findings]] | [[Necrotizing fasciitis other diagnostic studies|Other Diagnostic Studies]]
[[Necrotizing fasciitis history and symptoms|History and Symptoms]] | [[Necrotizing fasciitis physical examination|Physical Examination]] | [[Necrotizing fasciitis laboratory findings|Laboratory Findings]] | [[Necrotizing fasciitis electrocardiogram|Electrocardiogram]] | [[Necrotizing fasciitis x ray|X Ray]] | [[Necrotizing fasciitis CT|CT]] | [[Necrotizing fasciitis MRI|MRI]] | [[Necrotizing fasciitis ultrasound|Ultrasound]] | [[Necrotizing fasciitis other diagnostic studies|Other Diagnostic Studies]]


==Treatment==
==Treatment==
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Revision as of 18:55, 21 September 2017

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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], Cafer Zorkun, M.D., Ph.D. [3]

Synonyms and keywords:NF; Phagadena; Phagadena gangrenosum; Meleney’s gangrene; Hemolytic streptococcal gangrene; Flesh eating bacteria; Hospital gangrene; Acute dermal gangrene; Suppurative fasciitis; Synergistic necrotizing cellulitis; Gangrenous ulcer; Malignant ulcer; Putrid ulcer; Necrotizing erysipelas; Nonclostridial gas gangrene; Bacterial synergistic gangrene

Overview

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Screening

Natural History, Complications and Prognosis

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