Necrotizing fasciitis
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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 by Hippocrates in the fifth century B.C. as the complication of erysipelas[1]
- 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.[2]
Classification
- Necrotizing fasciitis may be classified according to international classification of diseases-10 (ICD-10) into:[3]
- 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
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.[4][5]
Case Fatality Rate
Age
Gender
Race
Developed countries
Developing countries
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
History and Symptoms | Physical Examination | Laboratory Findings | Electrocardiogram | X Ray | CT | MRI | Ultrasound | Other Imaging Findings | Other Diagnostic Studies
Treatment
Medical Therapy | Surgery | Primary Prevention | Secondary Prevention | Future or Investigational Therapies
Case Studies
See also
- Mucormycosis, a rare fungal infection which can present like necrotizing fasciitis
- Toxic shock syndrome
Template:Diseases of the musculoskeletal system and connective tissue
- ↑ Wasfy AA, Shoeb S, El-Mashad A, El-Ebrashy N, Higazi A, Gaber A; et al. (1978). "Detection of anaerobic respiratory bacteria with a new therapeutic approach". J Egypt Med Assoc. 61 (11–12): 757–61. PMID 556077.
- ↑ Caplehorn JR, Bell J (1991). "Methadone dosage and retention of patients in maintenance treatment". Med J Aust. 154 (3): 195–9. PMID 1988793.
- ↑ ICD-10 version:2016. http://apps.who.int/classifications/icd10/browse/2016/en#/M72.6 2016 Accessed on August 25,2016
- ↑ File TM, Tan JS, DiPersio JR (1998). "Group A streptococcal necrotizing fasciitis. Diagnosing and treating the "flesh-eating bacteria syndrome"". Cleve Clin J Med. 65 (5): 241–9. PMID 9599907.
- ↑ Chaouat Y, Chaouat D (1988). "[Primary hyperparathyroidism. History]". Rev Rhum Mal Osteoartic. 55 (7): 475–8. PMID 3051309.