Necrotizing Fasciitis

Abstract

Necrotizing fasciitis (NF) is a rare but rapidly progressive and potentially fatal disease condition. It is characterized by progressive inflammation and extensive necrosis of the subcutaneous tissue and fascia, sparing the underlying tissue. It is a poly-bacterial infection and is associated with profound systemic toxicity, considerable morbidity and a high mortality rate. The outcome is influenced by early recognition and radical surgical debridement. We present a report of six cases of NF who presented to our surgical service within the past 5 years.

Under Treated Necrotizing Fasciitis Masquerading as Ulcerated Edematous Mycobacterium ulcerans Infection (Buruli Ulcer)

“…4,5,22,23 A study of six patients diagnosed with NF and treated in the Department of Surgery, University College Hospital, in Ibadan, Nigeria, between January 1998 and December 2001, showed that the duration of symptoms ranged between 3 and 14 days. 24 The 7 day delay for our patient between the skin trauma and presentation to IME medical center is therefore more compatible with NF than with BU, as well as the reported edema on the day after this trauma. Diabetes, trauma, and old age frequently play a role in the rapid spread of NF.…”

Necrotising fasciitis: experience with 32 children

“…7,8,10 This report of 32 cases treated over 4 years is one of the largest paediatric series. Children aged (15 years constituted 57.1% of the total 56 patients treated, which is a higher proportion of children than in other reports.…”

“…15,18 NF has also been reported in children following chickenpox 16,19 or complicating abrasions, perineal abscesses and fistulae. 10,15,20,21 Occasionally, the initial trauma is so trivial that it is ignored by the patient. 22 Similar to other reports, 10 there was no obvious identifiable source of infection in 43.8% of our patients.…”

“…10,15,20,21 Occasionally, the initial trauma is so trivial that it is ignored by the patient. 22 Similar to other reports, 10 there was no obvious identifiable source of infection in 43.8% of our patients. In such cases, the disease might have started spontaneously or following unrecognised trauma.…”

“…2,[7][8][9] It is said to be a rare clinical entity (not a specific infection), often running a fulminant course, that is similar to and sometimes confused with clostridial myonecrosis. 10 Both earlier and recent reviews reported a yearly incidence of two to three cases in both children and adults, 2,10-13 although it is considered to affect more adults than children. 6,12,14 There are only a few reports of NF in children from either tropical Africa or the world at large.…”