Necrotizing fasciitis

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Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Necrotizing fasciitis from other Diseases
Epidemiology and Demographics
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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 in 1871 during civil war by a confederate army surgeon named Joseph Jones.
The association between bacterial infection and necrotizing fasciitis was made in 1918.
In 1952, the disease was named as necrotizing fasciitis.^[1]

Classification

Necrotizing fasciitis may be classified according to international classification of diseases-10 (ICD-10) into:^[2]

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

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.^[3]^[4]