What is Necrotizing Fasciitis?
Necrotizing Fasciitis is a rapidly progressive inflammatory infection of the fascia, with secondary necrosis of the subcutaneous tissues. The speed of spread is directly proportional to the thickness of the subcutaneous layer. Necrotizing fasciitis moves along the fascial plane.
Necrotizing Fasciitis has also been referred to as hemolytic streptococcal gangrene, Meleney ulcer, acute dermal gangrene, hospital gangrene, suppurative fasciitis, and synergistic necrotizing cellulitis. Fournier gangrene is a form of necrotizing fasciitis that is localized to the scrotum and perineal area.
Causes of Necrotizing Fasciitis
Several types of bacteria cause Necrotizing Fasciitis. The most common and well-known type is group A Streptococcus. However, this isn’t the only type of bacteria that can cause this infection. Other bacteria that can cause necrotizing fasciitis include:
- Aeromonas hydrophila
- Clostridium
- Escherichia coli
- Klebsiella
- Staphylococcus aureus
To get necrotizing fasciitis, you need to have the bacteria in your body. This typically occurs when the skin is broken. For example, the bacteria can enter your body through a cut, scrape, or surgical wound. These injuries don’t need to be large for the bacteria to take hold. Even a needle puncture can be enough.
Symptoms of Necrotizing Fasciitis
The initial symptoms of Necrotizing Fasciitis
- Warm and red skin
- Feeling of pulled muscle
- Flu
- Painful, red bump
- Oozing from the infected area,
- Discolored as it decays
- Blisters, bumps, black dots, or other skin lesions
Other Symptoms of Necrotizing Fasciitis include:
Diagnosis of Necrotizing Fasciitis
The following tests may help to identify Necrotising infection where the clinical picture is uncertain. However, note that there is no definitive test and surgery is required to confirm or rule out NF.
Blood tests
Bedside finger test
Microbiology
- Blood cultures
- Wound swab
- Gram stain and culture of affected tissues (from surgery or biopsy).
- Fungal culture
Radiology – note this cannot rule out NF, as there are many false negatives:
- Plain X-ray or CT scan
- MRI scans
- Ultrasound
Tissue oxygen saturation measured by near-infrared spectroscopy, as a bedside test.
Treatment of Necrotizing Fasciitis
Once the Diagnosis of Necrotising Fasciitis is confirmed, treatment should be initiated without delay.
- The patient must be hospitalised and is often admitted to an intensive care unit.
- The causative organism(s) should be identified and treated with high dose intravenous antibiotics
- Penicillin
- Clindamycin
- Metronidazole
- Cephalosporins
- Carbapenems
- Vancomycin
- linezolid
- It is absolutely vital than an experienced surgeon urgently removes all necrotic tissue (debridement).
- Supplemental oxygen, fluids and medicines may be needed to raise blood pressure.
- Hyperbaric oxygen and intravenous immunoglobulin may also be considered.
By : Natural Health News
