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Necrotizing Fasciitis

Updated : February 28, 2024





Background

Necrotizing fasciitis is also known as a Flesh-eating disease. The severe SSTIs (soft tissue infections) and skin that induces tissue damage to the subcutaneous layer and muscular fascia include Flesh-eating disease as a subset.

The fascial planes, where this illness often spreads, have a weak blood flow. As a result, the underlying tissues are initially untouched, which may delay detection but also surgical treatment.

The inflammatory process can progress quickly, infecting the fascia and peri-fascial planes in addition to the muscle, skin, and soft tissue directly above and below.

After surgery or any surgical intervention, including phlebotomy, necrotizing fasciitis can develop. Although the harmful bacteria are typically mixed, they do create gas.

Epidemiology

Every year, 0.4 out of every 100,000 Americans in the US are affected by necrotizing fasciitis. One out of every 100,000 persons experiences it in some parts of the world.

Anatomy

Pathophysiology

The muscular fascia is quickly traversed by the virus. The underlying skin, which first seems unaffected, will eventually take on an erythematous condition, reddish-purple to bluish-gray color after a few days. The skin’s surface would get indurated, puffy, glossy, and heated to the touch.

The skin is incredibly sensitive to palpation at this point, and it might also hurt excessively compared to the symptoms that are actually there. Cutaneous gangrene and bullae appear along with skin degradation, which starts between three to five days.

Due to the degradation of the surface neurons in the subcutaneous tissues and the thrombosed tiny veins, there is less pain in the area affected. Systemic signs including sepsis, fever, and tachycardia are signs that the infection is advanced.

The majority of SSTIs are frequently caused by anaerobes combined with aerobic bacteria. These bacteria include Bacteroides, proteus, clostridium, coliforms, pseudomonas, klebsiella, and peptostreptococcus.

Such organisms quickly infiltrated the deeper fascial lines and subcutaneous layer, occluding blood vessels and causing ischemia and damage to the tissue.

Etiology

Typically, necrotizing fasciitis is an acute condition that spreads quickly over many days. In about 80percent of the total of all instances, it is a direct consequence of serious infection acquired by a breach inside the skin’s structure.

Most of these specific source pathogens are transmitted by gram-positive coccus, particularly strains of Streptococci and Staphylococcus aureus.

A mix of anaerobic involvement and gram-negative also leads to polymicrobial illnesses. A background of drinking and diabetes characterizes most individuals. Flesh-eating disease is also more likely to strike those with hepatic cirrhosis.

Genetics

Prognostic Factors

With death rates above thirty percent, necrotizing fasciitis is a dangerous infection that poses a serious risk to life.

Specific streptococcus strains, old age, high blood sugar, immunosuppression, and delayed surgery have all been linked to poor prognoses.

Even those who survive experience a protracted recovery with severe functional losses.

Clinical History

Physical Examination

Age group

Associated comorbidity

Associated activity

Acuity of presentation

Differential Diagnoses

Laboratory Studies

Imaging Studies

Procedures

Histologic Findings

Staging

Treatment Paradigm

by Stage

by Modality

Chemotherapy

Radiation Therapy

Surgical Interventions

Hormone Therapy

Immunotherapy

Hyperthermia

Photodynamic Therapy

Stem Cell Transplant

Targeted Therapy

Palliative Care

Medication

Media Gallary

References

https://www.ncbi.nlm.nih.gov/books/NBK430756/

Necrotizing Fasciitis

Updated : February 28, 2024




Necrotizing fasciitis is also known as a Flesh-eating disease. The severe SSTIs (soft tissue infections) and skin that induces tissue damage to the subcutaneous layer and muscular fascia include Flesh-eating disease as a subset.

The fascial planes, where this illness often spreads, have a weak blood flow. As a result, the underlying tissues are initially untouched, which may delay detection but also surgical treatment.

The inflammatory process can progress quickly, infecting the fascia and peri-fascial planes in addition to the muscle, skin, and soft tissue directly above and below.

After surgery or any surgical intervention, including phlebotomy, necrotizing fasciitis can develop. Although the harmful bacteria are typically mixed, they do create gas.

Every year, 0.4 out of every 100,000 Americans in the US are affected by necrotizing fasciitis. One out of every 100,000 persons experiences it in some parts of the world.

The muscular fascia is quickly traversed by the virus. The underlying skin, which first seems unaffected, will eventually take on an erythematous condition, reddish-purple to bluish-gray color after a few days. The skin’s surface would get indurated, puffy, glossy, and heated to the touch.

The skin is incredibly sensitive to palpation at this point, and it might also hurt excessively compared to the symptoms that are actually there. Cutaneous gangrene and bullae appear along with skin degradation, which starts between three to five days.

Due to the degradation of the surface neurons in the subcutaneous tissues and the thrombosed tiny veins, there is less pain in the area affected. Systemic signs including sepsis, fever, and tachycardia are signs that the infection is advanced.

The majority of SSTIs are frequently caused by anaerobes combined with aerobic bacteria. These bacteria include Bacteroides, proteus, clostridium, coliforms, pseudomonas, klebsiella, and peptostreptococcus.

Such organisms quickly infiltrated the deeper fascial lines and subcutaneous layer, occluding blood vessels and causing ischemia and damage to the tissue.

Typically, necrotizing fasciitis is an acute condition that spreads quickly over many days. In about 80percent of the total of all instances, it is a direct consequence of serious infection acquired by a breach inside the skin’s structure.

Most of these specific source pathogens are transmitted by gram-positive coccus, particularly strains of Streptococci and Staphylococcus aureus.

A mix of anaerobic involvement and gram-negative also leads to polymicrobial illnesses. A background of drinking and diabetes characterizes most individuals. Flesh-eating disease is also more likely to strike those with hepatic cirrhosis.

With death rates above thirty percent, necrotizing fasciitis is a dangerous infection that poses a serious risk to life.

Specific streptococcus strains, old age, high blood sugar, immunosuppression, and delayed surgery have all been linked to poor prognoses.

Even those who survive experience a protracted recovery with severe functional losses.

https://www.ncbi.nlm.nih.gov/books/NBK430756/

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