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).

Causes

Necrotizing fasciitis may be caused by the following organisms

Type	Organism
Type 1 (70%-80% cases) Polymicrobial/Synergistic	● 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	● Beta-Hemolytic Streptococci group A (Streptococcus pyogenes) ● with/without Staphylococcus aureus ● Skin or throat derived
Type 3 (common in Asia) Gram negative monomicrobial NF (including marine related organisms)	● Vibrio spp mainly ● Raw oyster ingestion (V.Vulnficus) ● Wound contamination with sea water ● Non-vibrio spp (Pasteurella multocida, Haemophilus influenzae, Klebsiella spp and Aeromonas spp)
Type 4 (Fungal)	● Candida (Immunocompromised patients) ● Zygomycetes such as Mucor and Rhizopus spp (Immunocompetent patients)