Necrotizing fasciitis

Immediate surgical debridement and intravenous broad-spectrum antibiotics are key to reducing the mortality associated with necrotizing fasciitis. 

Necrotizing fasciitis (NF) is an uncommon, rapidly progressive, life-threatening infection of the subcutaneous tissue and fascia. Its associated mortality rate is approximately 25% and is nearly 70% in patients who present with septic shock.3,19... 

Cunningham fD, Silver L, Rudikoff D. Necrotizing fasciitis a plea for early diagnosis and treatment. Mount Sinai J Med 2001 68(4—5) 253-261. 

Necrotizing fasciitis A severe soft-tissue infection involving the... 

Suggested Alternatives for Differential Diagnosis Scarlet fever, cellulitis, cat scratch disease, gas gangrene, necrotizing fasciitis, tick-borne diseases such as Rocky Mountain spotted fever, pneumonia, septic shock, acute respiratory distress syndrome (ARDS), disseminated intravascular coagulation. 

Necrotizing fasciitis caused byS. pyogenes should be treated with the combination of... 

In fasciitis or necrotizing infections caused by beta-hemolytic streptococci of group A, parenteral high-dose penicillin combined with clindamycin is the treatment of choice. For the treatment of abscesses, antibiotics which are able to kill large quantities of resting bacteria, such as clindamycin and the quinolones, are preferred. 

B) Necrotizing fasciitis eczema predisposes an individual to this toxicity of ibuprofen... 

C. The likelihood of gastric ulceration and GI bleeding is increased by heavy alcohol use, poor health, advanced age, long-term NS AID use, and use of drugs such as corticosteroids and anticoagulants. Ibuprofen is not converted to a cardiotoxic metabolite. Dermal toxicities, such as epidermal necrolysis, are rare complications of ibuprofen therapy, but necrotizing fasciitis is not one of them. Confusion and ataxia are not side effects associated with ibuprofen, nor is eosinophilia. 

Lonergan S, Rodriguez RM, Schaulis M, Navaran P. A case series of patients with black tar heroin-associated necrotizing fasciitis. J Emerg Med 2004 26(1) 47-50. 

Fortype II necrotizing fasciitis, use clindamycin 0,5-0,9 g IV every 8 hours (in children, dindamydn 15 mg/k day IV in 3 divided doses). 

Patient C. A 49-year-old woman reported by her family to have hepatitis C was evacuated from New Orleans after a boat rescue. She visited an Arkansas hospital on September 4 with bullae, septic shock, and necrotizing fasciitis on her left leg, which was extensively debrided. V. vulnificus was isolated from her blood. As of September 12, she was being treated with ceftazidime and doxycycline and remained in critical condition. 

Necrotizing fasciitis was reported in three patients, two of whom died as a consequence of severe local reactions associated with intramuscular diclofenac (43). 

Pillans PI, O Connor N. Tissue necrosis and necrotizing fasciitis after intramuscular administration of diclofenac. Ann Pharmacother 1995 29(3) 264-6. 

Severe necrotizing fasciitis has been reported in a patient who was given infliximab (39). 

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