Necrotizing fasciitis

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Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Necrotizing fasciitis from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Criteria

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X Ray

CT

MRI

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Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Future or Investigational Therapies

Case Studies

Case #1

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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: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

Overview

Historical Perspective

  • Necrotizing fasciitis was first described by Hippocrates in the fifth century B.C. as the complication of erysipelas[1]
  • 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.[2]

Classification

  • Necrotizing fasciitis may be classified according to international classification of diseases-10 (ICD-10) into:[3]
  • M72.6 Necrotizing fasciitis
  • Based on microbiological findings, necrotizing fasciitis may be classified into four types
  • Type 1: Polymicrobial:
  • Type 2: Group A streptococcal
  • Type 3: Gas gangrene or clostridial myonecrosis
  • Type 4:
Type Pathogens
Type 1 or Polymicrobial Staphylococcus aureus
● Haemophilus
● Vibrio
● Several other aerobic and anaerobic strains
Type 2 or Monomicrobial ● Beta hemolytic streptococcus group A (Streptococcus pyogenes)
● High spiky fever
● Firm mass with pus
Type 3 or
Gas gangrene or
Clostridial myonecrosis
● Fluctuant mass
● Dissemination of infection
Septicemia
Acute renal failure
● Metastatic abscesses
Septic shock
● Death
Type 4

Pathophysiology

Causes

Differentiating Necrotizing fasciitis from other Diseases

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.[4][5]

Case Fatality Rate

Age

Gender

Race

Developed countries

Developing countries

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms | Physical Examination | Laboratory Findings | Electrocardiogram | X Ray | CT | MRI | Ultrasound | Other Imaging Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Surgery | Primary Prevention | Secondary Prevention | Future or Investigational Therapies

Case Studies

Case#1

See also

Template:Diseases of the musculoskeletal system and connective tissue


Template:WikiDoc Sources

  1. Wasfy AA, Shoeb S, El-Mashad A, El-Ebrashy N, Higazi A, Gaber A; et al. (1978). "Detection of anaerobic respiratory bacteria with a new therapeutic approach". J Egypt Med Assoc. 61 (11–12): 757–61. PMID 556077.
  2. Caplehorn JR, Bell J (1991). "Methadone dosage and retention of patients in maintenance treatment". Med J Aust. 154 (3): 195–9. PMID 1988793.
  3. ICD-10 version:2016. http://apps.who.int/classifications/icd10/browse/2016/en#/M72.6 2016 Accessed on August 25,2016
  4. File TM, Tan JS, DiPersio JR (1998). "Group A streptococcal necrotizing fasciitis. Diagnosing and treating the "flesh-eating bacteria syndrome"". Cleve Clin J Med. 65 (5): 241–9. PMID 9599907.
  5. Chaouat Y, Chaouat D (1988). "[Primary hyperparathyroidism. History]". Rev Rhum Mal Osteoartic. 55 (7): 475–8. PMID 3051309.