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__NOTOC__
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{{Necrotizing fasciitis}}
{{Necrotizing fasciitis}}
{{CMG}}; {{AE}} {{YK}}


{{CMG}}
==Overview==
During early stages, the symptoms of necrotizing fasciitis are non-specific. Symptoms include [[fever]], [[nausea]], and [[fatigue]].<ref name="pmid19826154">{{cite journal| author=Puvanendran R, Huey JC, Pasupathy S| title=Necrotizing fasciitis. | journal=Can Fam Physician | year= 2009 | volume= 55 | issue= 10 | pages= 981-7 | pmid=19826154 | doi= | pmc=2762295 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19826154  }} </ref><ref name="pmid17683625">{{cite journal| author=Taviloglu K, Yanar H| title=Necrotizing fasciitis: strategies for diagnosis and management. | journal=World J Emerg Surg | year= 2007 | volume= 2 | issue=  | pages= 19 | pmid=17683625 | doi=10.1186/1749-7922-2-19 | pmc=1988793 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17683625  }} </ref>
 
==History==
Specific areas of focus when obtaining a history from the patient include history of:<ref name="pmid19826154">{{cite journal| author=Puvanendran R, Huey JC, Pasupathy S| title=Necrotizing fasciitis. | journal=Can Fam Physician | year= 2009 | volume= 55 | issue= 10 | pages= 981-7 | pmid=19826154 | doi= | pmc=2762295 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19826154  }} </ref><ref name="pmid17683625">{{cite journal| author=Taviloglu K, Yanar H| title=Necrotizing fasciitis: strategies for diagnosis and management. | journal=World J Emerg Surg | year= 2007 | volume= 2 | issue=  | pages= 19 | pmid=17683625 | doi=10.1186/1749-7922-2-19 | pmc=1988793 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17683625  }} </ref>
*Minor [[trauma]]
*Insect and human bites (soft tissue injury penetrating lesions)
*Recent surgery
*Injection sites
*Illicit [[Drug abuse|intravenous drug use]]
*Previous [[MRSA]] colonization or [[clindamycin]]-resistant [[streptococcus|streptococcal infection]]
*Skin infection and [[ulcer]]s
*Foreign travel (resistant or unusual organisms)
*[[Trauma]] involving soil contamination ([[fungal]] culture)
*Raw seafood ingestion
*Wound exposure to sea water
*[[Tonsillitis]]
*Close contacts with [[impetigo]] or [[sore throat]]
*[[NSAID]]'s use
*[[Vaginitis]]
*[[Immunosupression]]
*[[Diabetes mellitus]]
*[[Peripheral vascular disease]]
*[[Alcoholism]]
*[[Carcinoma]]
*[[Smoking]]
*[[Varicella|Varicella infection]]
*[[Burns]]


==Symptoms==
==Symptoms==
The infection begins locally, at a site of [[Physical trauma|trauma]], which may be severe (such as the result of [[surgery]]), minor, or even non-apparent. The affected skin is classically, at first, very painful without any grossly visible change. With progression of the disease, tissue becomes swollen, often within hours. Diarrhea and vomiting are common symptoms as well. Inflammation does not show signs right away if the bacteria is deep within the tissue. If it is ''not'' deep, signs of inflammation such as redness and swollen or hot skin show very quickly. Skin color may progress to violet and blisters may form, with subsequent [[necrosis]] (death) of the subcutaneous tissues. Patients with necrotizing fasciitis typically have a [[fever]] and appear very ill. More severe cases progress within hours, and the [[mortality rate]] is high, about 30%. Even with medical assistance, antibiotics take a great deal of time to react to the bacteria, allowing the infection to progress to a more serious state.<ref>http://www.webmd.com/a-to-z-guides Necrotizing Fasciitis Flesh Eating Bacteria Overview</ref> <ref>Tiu,A et al, ANZ J Surg. 2005 Jan-Feb;75(1-2):32-4 </ref>
*Symptoms of necrotizing fasciitis include:<ref name="pmid19826154">{{cite journal| author=Puvanendran R, Huey JC, Pasupathy S| title=Necrotizing fasciitis. | journal=Can Fam Physician | year= 2009 | volume= 55 | issue= 10 | pages= 981-7 | pmid=19826154 | doi= | pmc=2762295 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19826154  }} </ref><ref name="pmid17683625">{{cite journal| author=Taviloglu K, Yanar H| title=Necrotizing fasciitis: strategies for diagnosis and management. | journal=World J Emerg Surg | year= 2007 | volume= 2 | issue=  | pages= 19 | pmid=17683625 | doi=10.1186/1749-7922-2-19 | pmc=1988793 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17683625  }} </ref>
 
{| class="wikitable"
 
|-
 
! Type 1 NF
 
! Type 2 NF
 
|-
 
| • Intense [[pain]] (out of proportion to examination) <br> • [[Numbness]] <br> • [[Fatigue]] <br> • [[Fever]] <br> • [[Sensorium|Altered sensorium]]
 
| • Intense [[pain]] (out of proportion to examination) <br> • GI ([[nausea]], [[vomiting]], and [[diarrhea]]) <br> • [[Fever]] <br> • [[Flu]] like symptoms ([[aches]], [[chills]], and [[fever]]) <br> • [[Fatigue]]
 
|}
 
*Based on severity of symptoms, necrotizing fasciitis is classified into:<ref name="pmidPMID 15735411">{{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=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 (within 24 h of the inciting event):
:**[[Vibrio]] species are the notable causative agents
:**Extremely [[fulminant]] course with considerable involvement of surrounding tissue
:**Severe [[septicemia]]
:**Multiorgan failure
:*Sub-acute (indolent):
:**Areas of [[soft tissue]] infections with minimal pain and discomfort
:**Progress over weeks to months


==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

During early stages, the symptoms of necrotizing fasciitis are non-specific. Symptoms include fever, nausea, and fatigue.[1][2]

History

Specific areas of focus when obtaining a history from the patient include history of:[1][2]

Symptoms

  • Symptoms of necrotizing fasciitis include:[1][2]
Type 1 NF Type 2 NF
• Intense pain (out of proportion to examination)
• Numbness
• Fatigue
• Fever
• Altered sensorium 		• Intense pain (out of proportion to examination)
• GI (nausea, vomiting, and diarrhea)
• Fever
• Flu like symptoms (aches, chills, and fever)
• Fatigue
  • Based on severity of symptoms, necrotizing fasciitis is classified into:[3]
  • Hyperacute (within 24 h of the inciting event):
    • Vibrio species are the notable causative agents
    • Extremely fulminant course with considerable involvement of surrounding tissue
    • Severe septicemia
    • Multiorgan failure
  • Sub-acute (indolent):
    • Areas of soft tissue infections with minimal pain and discomfort
    • Progress over weeks to months

References

  1. ↑ 1.0 1.1 1.2 Puvanendran R, Huey JC, Pasupathy S (2009). "Necrotizing fasciitis". Can Fam Physician. 55 (10): 981–7. PMC 2762295. PMID 19826154.
  2. ↑ 2.0 2.1 2.2 Taviloglu K, Yanar H (2007). "Necrotizing fasciitis: strategies for diagnosis and management". World J Emerg Surg. 2: 19. doi:10.1186/1749-7922-2-19. PMC 1988793. PMID 17683625.
  3. ↑ Wong CH, Wang YS (2005). "The diagnosis of necrotizing fasciitis". Curr Opin Infect Dis. 18 (2): 101–6. PMID 15735411 PMID 15735411 Check |pmid= value (help).
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