CT findings in necrotising fasciitis — A report of four cases

Walshaw, C.F.; Deans, Heather

doi:10.1016/s0009-9260(96)80164-4

Cited by 41 publications

(24 citation statements)

References 11 publications

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“…Modalities such as computed tomography (CT) scans or magnetic resonance imaging of the affected parts have been shown to be able to detect early necrotizing fasciitis. [16][17][18][19][20][21][22][23][24][25][26][27] Other recently described diagnostic adjuncts that may be helpful include the laboratory risk indicator for necrotizing fasciitis (LRINEC) score. [28][29][30] The LRINEC score, based on routinely available laboratory tests for assessment of severe soft-tissue infections, is a predictive model developed specifically to distinguish necrotizing fasciitis from other more benign soft-tissue infections such as cellulitis.…”

Section: Discussionmentioning

confidence: 99%

Staging of necrotizing fasciitis based on the evolving cutaneous features

2007

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Section: Discussionmentioning

confidence: 99%

Staging of necrotizing fasciitis based on the evolving cutaneous features

2007

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“…However, invasion through the anal sphincter can allow for spread along the rectum into the presacral space, retrovesical space, and pelvirectal tissue with subsequent involvement of the retroperitoneum. 1 Computed tomography and magnetic resonance imaging can demonstrate subcutaneous and fascial edema and tissue gas [15][16][17] ; however, imaging should not delay surgical therapy. Frozen section examination of biopsy specimens demonstrating an intact epidermis, dermal necrosis, vascular thrombosis, neutrophilic infiltration, and subcutaneous tissue necrosis has been helpful for early diagnosis.…”

Section: Discussionmentioning

confidence: 99%

A Diabetic Male With a Suprapubic Mass and Painful Penis and Scrotum

Chun¹

2006

Infectious Diseases in Clinical Practice

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Fournier's gangrene is a life-threatening necrotizing synergistic fasciitis of the perineum, abdominal wall, and genitalia [Surg Clin North Am 2002;82:1213; Urol Clin North Am 1991;26:841]. We describe a case of a 66-year-old man whose atypical presentation posed a diagnostic and clinical challenge of such a urological emergency. Clinicians need to have a high index of suspicion for this disease in individuals with predisposing or associated conditions, given the risk for widespread extension and impact on patients' outcome. (Infect Dis Clin Pract 2006;14:65-67) CASE REPORTA 66-year-old African American male with a history of diabetes mellitus and peripheral vascular disease was admitted in December 2004 to a hospital emergency department with fever, chills, dysuria, and fluctuating blood sugars. He denied any penile discharge, unprotected intercourse, or costovertebral tenderness. He reported falling without loss of consciousness before arrival to the emergency department. Physical examination was unremarkable; there was no prostate tenderness. Values for standard laboratory tests revealed the following: white blood cell count 41 Â 1000/mm 3 , 70% neutrophils, 19% bands; urinalysis, 30 white blood cells per high-power field, negative nitrite, 2+ leukocyte esterase, moderate bacteria; sodium 133 mmol/L, potassium 3.3 mmol/L, bicarbonate 15 mmol/L, creatinine 1.1 mg/dL, lactate 2.9 mmol/L (range 0.5-2.2). No abnormalities were seen on chest radiograph and renal ultrasound.The patient was treated for a presumptive urinary infection with a fluoroquinolone. One day after discharge, the patient represented after awaking from sleep with a painful penis and scrotum and a weak interrupted urinary stream. Findings on physical examination revealed a nontoxic man with stable vital signs and a tender nonfluctuant suprapubic mass with scrotal, penile, and perineal edema. Laboratory analysis revealed white blood cell count 70.2 Â 1000/mm 3 , 86% neutrophils, 7% bands; sodium 132 mmol/L, potassium 4.0 mmol/L, bicarbonate 18 mmol/L, creatinine 0.7 mg/dL, lactate 0.7 mmol/L. Blood and urine cultures were negative. Computed tomography examination of the abdomen and pelvis demonstrated air in the subcutaneous tissue overlying the pelvis and perineum, along the fascial planes, extending halfway to the umbilicus (Fig. 1). These findings were suggestive of Fournier's gangrene.The patient was immediately taken to surgery for debridement of the perineum and corpora spongiosum. The patient was treated with intravenous imipenem and clindamycin. Wound Gram stain and culture revealed budding yeast that cultured out as Candida albicans; pathological tissue examination from the perineum revealed necrotic involvement of the skin and subcutaneous fat and fascia. Special stains for bacteria, acid-fast bacilli, and fungi were negative. The patient was taken to the operating room daily for repeated examination and debridement ultimately requiring a penectomy 21 days after initial debridement. Perineal wound vacuum cultures from 6 days after p...

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“…The condition can result from dental (dental abscess, gingivitis, pulpitis, etc. ), [28,29] sinus, [30] peritonsillar, [31,32] and salivary gland [26] infections, or from infections secondary to surgery, [33] insect bites, or trauma [34]. Dental infections are the most common etiologic factor, followed by trauma, peritonsillar and pharyngeal abscesses, and osteoradionecrosis.…”

Section: Clinical Featuresmentioning

confidence: 99%

Cervicofacial Necrotising Fasciitis of Odontogenic Origin: A Review

N¹

2012

J Clin Cell Immunol 2012

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CT findings in necrotising fasciitis — A report of four cases

Cited by 41 publications

References 11 publications

Staging of necrotizing fasciitis based on the evolving cutaneous features

Staging of necrotizing fasciitis based on the evolving cutaneous features

A Diabetic Male With a Suprapubic Mass and Painful Penis and Scrotum

Cervicofacial Necrotising Fasciitis of Odontogenic Origin: A Review

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