Necrotizing fasciitis: Difference between revisions

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Case #1
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Revision as of 19:53, 29 August 2016

For patient information on this page, click here

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

Classification

Necrotizing fasciitis may be classified according to international classification of diseases-10 (ICD-10) into:^[1]

M72.6 Necrotizing fasciitis

Based on microbiological findings, necrotizing fasciitis may be classified into four types

Type	Organism
Type 1 or Polymicrobial	● Non-Group A streptococci ● Anaerobes including clostridia ● Facultative anaerobes ● Enterobacteria
Type 2 or Monomicrobial	● Beta-Hemolytic Streptococci group A (Streptococcus pyogenes)
Type 3 or Gas gangrene or Clostridial myonecrosis	● Marine vibrio vulnificus
Type 4	● MRSA

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.^[2]^[3]

Case Fatality Rate

Age

Gender

Race

Developed countries

Developing countries

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Treatment

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

Case Studies

Case#1

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 ==[[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]]==