Necrotizing fasciitis causes

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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

The causative organisms vary depending on the type of necrotizing fasciitis: Type I (polymicrobial), Type II (monomicrobial), Type III (Gram negative monomicrobial, including marine related organisms) and Type IV (fungal).[1]

Causes

Necrotizing fasciitis may be caused by the following organisms:[2]

Type Organism
Type 1 (70%-80% cases)
Polymicrobial/Synergistic[3][4][5]
● Mixed aerobes, anaerobes and facultative anerobic bacteria
● Often bowel flora-derived
● Affects immunocomprmised or those with underlying abominal pathology
Type 2 (20% to 30% cases)
Monomicrobial[6][7]
Beta-Hemolytic Streptococci group A (Streptococcus pyogenes)
● With/without Staphylococcus aureus
● Skin or throat derived
Type 3 (common in Asia)
Gram negative monomicrobial (including marine related organisms)[8][9]
Vibrio spp mainly
● Raw oyster ingestion (Vibrio vulnificus)
● Wound contamination with sea water
● Non-vibrio spp (Pasteurella multocida, Haemophilus influenzae, Klebsiella spp. and Aeromonas spp)
Type 4 (Fungal)[1] Candida (Immunocompromised patients)
Zygomycetes such as Mucor and Rhizopus spp (Immunocompetent patients)

References

  1. 1.0 1.1 Misiakos EP, Bagias G, Patapis P, Sotiropoulos D, Kanavidis P, Machairas A (2014). "Current concepts in the management of necrotizing fasciitis". Front Surg. 1: 36. doi:10.3389/fsurg.2014.00036. PMC 4286984. PMID 25593960.
  2. Shimizu T, Tokuda Y (2010). "Necrotizing fasciitis". Intern Med. 49 (12): 1051–7. PMID 20558917.
  3. Salcido RS (2007). "Necrotizing fasciitis: reviewing the causes and treatment strategies". Adv Skin Wound Care. 20 (5): 288–93, quiz 294-5. doi:10.1097/01.ASW.0000269317.76380.3b. PMID 17473566.
  4. Anaya DA, McMahon K, Nathens AB, Sullivan SR, Foy H, Bulger E (2005). "Predictors of mortality and limb loss in necrotizing soft tissue infections". Arch Surg. 140 (2): 151–7, discussion 158. doi:10.1001/archsurg.140.2.151. PMID 15723996.
  5. Miller LG, Perdreau-Remington F, Rieg G, Mehdi S, Perlroth J, Bayer AS; et al. (2005). "Necrotizing fasciitis caused by community-associated methicillin-resistant Staphylococcus aureus in Los Angeles". N Engl J Med. 352 (14): 1445–53. doi:10.1056/NEJMoa042683. PMID 15814880.
  6. Shiroff AM, Herlitz GN, Gracias VH (2014). "Necrotizing soft tissue infections". J Intensive Care Med. 29 (3): 138–44. doi:10.1177/0885066612463680. PMID 23753218.
  7. Umbert IJ, Winkelmann RK, Oliver GF, Peters MS (1989). "Necrotizing fasciitis: a clinical, microbiologic, and histopathologic study of 14 patients". J Am Acad Dermatol. 20 (5 Pt 1): 774–81. PMID 2654217.
  8. Howard RJ, Pessa ME, Brennaman BH, Ramphal R (1985). "Necrotizing soft-tissue infections caused by marine vibrios". Surgery. 98 (1): 126–30. PMID 4012603.
  9. 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.

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