Necrotizing Fasciitis in Infancy: Report of Three Cases and Review of the Literature

Abstract

Necrotizing fasciitis exists on a continuum of soft tissue infections between cellulitis and myonecrosis. It has been uncommonly reported in infancy (1-10). The diagnosis depends on recognition of the characteristic rapidly progressive clinical course and demonstration of full-thickness skin necrosis with involvement of the fascial planes overlying the muscle. The organisms most often recovered are beta-hemolytic Streptococcus or Staphylococcus aureus, but other aerobic and anaerobic organisms in single or mixed infection have been reported (1, 2, 11, 12). This infection has a significant mortality rate, necessitating early, aggressive, specific medical and surgical treatment.

999 abuse: Do mothers know what they are using?

“…Onset is typically insidious and follows trauma. The condition rarely occurs in infants and children (5,6). Pediatric cases have been reported from countries where poor hygiene is prevalent.…”

“…Necrotizing fasciitis is a progressive, swiftly spreading, inflammatory infection located in the deep fascia, with secondary necrosis of the deep tissues (5)(6)(7)(8)(9). Because of the presence of gas-forming organisms such as Clostridium, subcutaneous air is classically described in necrotizing fasciitis (5-9,11), which may be seen only on radiographs.…”

“…Necrotizing fasciitis is a collective term to describe bacterial infections that involve subcutaneous tissues, fascia, and muscle (5)(6)(7)(8)(9). Onset is typically insidious and follows trauma.…”

Necrotizing fasciitis: a rare complication of neonatal necrotizing enterocolitis

“…The organisms most often discovered on wound cultures are b-hemolytic Streptococcus or Staphylococcus [4], although multiple other aerobic and/or anaerobic bacterial and fungal organisms may be involved. In our case, the patient's wound culture demonstrated both Citrobacter and Enterobacter.…”

“…Traditional risk factors for neonatal necrotizing fasciitis include omphalitis [1,2], Hirschsprung enterocolitis [3], staphylococcal folliculitis, bullous impetigo [4], or following surgical procedures. In addition, other risk factors in our case include the bacteremia associated with NEC, reduced tissue perfusion associated with septic shock, and possibly, inoculation of the abdominal wall with the stomas.…”