Necrotizing fasciitis risk factors

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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

Common risk factors in the development of necrotizing fasciitis include trauma, alcoholism, diabetes, intravenous drug abuse, immunosupression and burns.

Risk Factors

Common risk factors in the development of necrotizing fasciitis include:[1][2][3][4][5][6]

Type 1 Type 2 Type 3 Type 4
• Alcoholism
• Antecedent trauma
• Carcinoma
• Cardiopulmonay disease
• Diabetes
• Iatrogenic procedures
• Immunosupression (e.g., HIV and corticosteroid use)
• Intravenous drug abuse
• Male gender
• Peripheral vascular disease
• Recent surgery
• Smoking
• Advanced age
• Alcoholism
• Antecedent trauma
• Carcinoma
• Cardiopulmonay disease
• Diabetes
• Immunosupression (e.g., HIV and corticosteroid use)
• Intravenous drug abuse
• Male gender
• Peripheral vascular disease
• Recent surgery
• Exposure to children with sore throat
• HLA class II haplotype
• Lack of specific anti-GAS antibodies
• Varicella infection
• Advanced age
• Raw oyster ingestion
• Wound contamination with sea water
• Immunosupression
• Advanced age
• Immunosupression
• Antecedent trauma
• Burns
• Advanced age

Role of NSAIDS in GASNF

  • NSAIDS mask the signs and symptoms leading to delay in diagnosis of existing infection.[7] [8]
  • NSAIDS potentiate the development of renal failure by inhibiting renal prostaglandin synthesis and prevent the respiratory burst necessary for phagocytes to kill intracellular organisms leading to impairment of natural host defense mechanisms.

References

  1. Chen JL, Fullerton KE, Flynn NM (2001). "Necrotizing fasciitis associated with injection drug use". Clin Infect Dis. 33 (1): 6–15. doi:10.1086/320874. PMID 11389488.
  2. Elliott DC, Kufera JA, Myers RA (1996). "Necrotizing soft tissue infections. Risk factors for mortality and strategies for management". Ann Surg. 224 (5): 672–83. PMC 1235444. PMID 8916882.
  3. McHenry CR, Piotrowski JJ, Petrinic D, Malangoni MA (1995). "Determinants of mortality for necrotizing soft-tissue infections". Ann Surg. 221 (5): 558–63, discussion 563-5. PMC 1234638. PMID 7748037.
  4. Misiakos EP, Bagias G, Patapis P, Sotiropoulos D, Kanavidis P, Machairas A (2014). "Current concepts in the management of necrotizing fasciitis". Front Surg. 1: 36. doi:10.3389/fsurg.2014.00036. PMC 4286984. PMID 25593960.
  5. Francis KR, Lamaute HR, Davis JM, Pizzi WF (1993). "Implications of risk factors in necrotizing fasciitis". Am Surg. 59 (5): 304–8. PMID 8489099.
  6. Goh T, Goh LG, Ang CH, Wong CH (2014). "Early diagnosis of necrotizing fasciitis". Br J Surg. 101 (1): e119–25. doi:10.1002/bjs.9371. PMID 24338771.
  7. Holder EP, Moore PT, Browne BA (1997). "Nonsteroidal anti-inflammatory drugs and necrotising fasciitis. An update". Drug Saf. 17 (6): 369–73. PMID 9429836.
  8. NSAIDS and NF http://www.medsafe.govt.nz/Profs/puarticles/necf.htm (2000) Accessed on September 11, 2016