Necrotizing fasciitis: an update on epidemiology, diagnostic methods, and treatment

Abstract

Purpose of review The aim of this review is to discuss the latest evidence of epidemiology, diagnostic methods, and treatment of necrotizing soft tissue infections (NSTIs) with a particular focus on necrotizing fasciitis (NF). Recent findings NSTIs have been historically referred to as NF but encompass a broader range of infections, with variable rates ranging from 0.86 to 32.64 per 100 000 person-years, influenced by factors such as climate and seasonal variations. They have diverse microbiological profiles categorized into different types based on the involved pathogens, including polymicrobial or monomicrobial infections caused by organisms such as group A streptococcus (GAS), Staphylococcus aureus, some Gram-negative pathogens, and filamentous fungi following trauma and natural disasters. Diagnosis relies on clinical symptoms and signs, laboratory markers, and imaging. However, the gold standard for diagnosis remains intraoperative tissue culture. Treatment involves repeated surgical debridement of necrotic tissues in addition to intravenous antibiotics. Adjuvant therapies with intravenous immunoglobulin (IVIG) and hyperbaric oxygen therapy (HBOT) might have a role. Soft tissue reconstruction may be necessary following surgery. Summary Prompt diagnosis and proper medical and surgical management of NSTI will improve outcomes.

Case report: A rare case of simultaneous necrotizing fasciitis of the breast and forearm

“…Necrotizing fasciitis (NF) is a rapidly progressive skin infection characterized by necrosis of fascia and subcutaneous tissue ( 1 ). The incidence of necrotizing fasciitis is low, estimated at 0.86 to 32.64 cases per 100,000 population ( 2 ). Due to the insidious onset and rapid progression of necrotizing fasciitis, the disease is easily misdiagnosed in its early stages, and if left untreated, the resultant disability and mortality rates are extremely high ( 3 ).…”