Pyelonephritis can be a source of a life threatening necrotizing myofasciitis

Background: Necrotizing fasciitis is a serious infection of skin and soft tissues that rapidly progresses along the deep fascia. It’s a fatal infection with high mortality if treatment delayed. Early diagnosis, surgical debridement and broad-spectrum antibiotic therapy are the optimal treatments to reduce the mortality. Objective: The aims were to identify risk factors for Necrotizing fasciitis and to describe the outcome of management. Methods: A prospective descriptive study was conduted at AL-THAWRA HOSIPTAL located in Sana’a, Yemen. All medical records of patients with confirmed NF who admitted to surgical department between January 2020 and January 2021 were reviewed. Results: The study enrolled 54 patients diagnosed with Necrotizing fasciitis. Male patients were 43 patients (79.6%) and female patients were 11 patients (20.3%). The age rang was 9 – 75 years old and the peak age incidence was at 46–60 years (33.3%). The incidence of NF increases with aging, male gander (79.6%), in comorbid patients (64.9%) especially DM (37%). The etiologies of NF were trauma in (16.6%) and perianal abscess in (14.8%), but (27.7%) of NF patients hadn’t specific cause. The defected wound was treated by skin graft in (32.5%) and primary closure in (27.5%). The mortality rate was (27.7% n=15); (60%) of them died on first 5 days. Septic shock was the reason of death in (73.2%). The higher mortality rate was seen at male gander (66.6%), age group > 60 years (46.6%), in patients who presented in shocked state (73.3%) and in comorbid patients (73.3%). Conclusion: Necrotizing fasciitis represents a life threatening condition with challenges in diagnosis. Incidence and mortality of NF are common in male gander, an elderly patient, or in who suffers of comorbidities; especially DM.

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Necrotizing Fasciitis of Face in Odontogenic Infection: A Rare Clinical Entity

World Journal of Dentistry ◽

10.5005/jp-journals-10015-1169 ◽

2012 ◽

Vol 3 (3) ◽

pp. 261-264 ◽

Cited By ~ 1

Author(s):

GK Vivek ◽

Ranjith Singh ◽

GC Veena ◽

Prappanna Arya

Keyword(s):

Necrotizing Fasciitis ◽

Subcutaneous Tissue ◽

Neck Region ◽

Odontogenic Infection ◽

Clinical Entity ◽

Rare Clinical Entity ◽

Head And Neck Region ◽

The Face ◽

Life Threatening ◽

Group A

ABSTRACT Necrotizing fasciitis is a progressive, life-threatening, bacterial infection of the skin, the subcutaneous tissue and the underlying fascia, in most cases caused by β-hemolytic group A Streptococcus. Only early diagnosis and aggressive therapy including broad spectrum antibiotics and surgical intervention can avoid systemic toxicity with a high mortality rate. This disease is commonly known to occur in the lower extremities and trunk, and only rarely in the head and neck region, the face being rarest finding. When located in the face necrotizing fasciitis is associated with severe cosmetic and functional complication due to the invasive nature, infection and often due to the necessary surgical treatment. In the following article, we present the successful diagnosis and management of an isolated facial necrotizing fasciitis as a consequence of odontogenic infection. How to cite this article Vivek GK, Singh R, Veena GC, Arya P. Necrotizing Fasciitis of Face in Odontogenic Infection: A Rare Clinical Entity. World J Dent 2012;3(3):261-264.

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Diagnosis and management of necrotizing fasciitis in the light of the recent recommendations

Modern medical technologies ◽

10.34287/mmt.2(41).2019.15 ◽

2019 ◽

Vol 41 part 1 (2) ◽

pp. 77-84

Author(s):

C. O. Kosulnikov ◽

V. N. Lisnichaya ◽

A. M. Besedin ◽

S. І. Karpenko ◽

S. A. Tarnopolsky ◽

...

Keyword(s):

Necrotizing Fasciitis ◽

Soft Tissues ◽

Subcutaneous Fat ◽

Surgical Debridement ◽

Type I ◽

Cause Of Deaths ◽

Life Threatening ◽

Management Modality ◽

Closure Method ◽

Primary Management

Summary: Necrotizing fasciitis is a rare but life-threatening infection of the soft tissues. It is characterized by spreading inflammation and necrosis starting from the fascia, muscles, and subcutaneous fat, with subsequent necrosis of the overlying skin. Necrotizing fasciitis is classified into four types, depending on microbiological findings. The diagnosis of this disease is difficult. Late diagnosis is observed in 85–100% of cases and is considered the only cause of deaths. Emergency surgical debridement is the primary management modality for necrotizing fasciitis. Vacuum assisted closure therapy is fast and effective wound closure method. Antibiotics and surgical debridement play a key role in the treatment of necrotizing fasciitis.In our hospital, there were 75 patients with necrotizing fasciitis in the last 5 years (type I – 92%, type II – 8%). We observed localization of necrotizing fasciitis in the perineum (32%), upper extremities and chest (25%), lower extremities (28%), abdominal wall and retroperitoneal space (15%). Mortality was 9,5%. Keywords: necrotizing fasciitis, sepsis, surgical debridement.

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Necrotizing Fasciitis of The Abdominal Wall Following Colonoscopy with Fatal Outcome - A Case Report

Surgical Case Reports ◽

10.31487/j.scr.2019.05.06 ◽

2019 ◽

pp. 1-3

Author(s):

Daniel Matz ◽

Oleg Heizmann

Keyword(s):

Soft Tissue ◽

Necrotizing Fasciitis ◽

Soft Tissue Infection ◽

Group A Streptococcus ◽

Subcutaneous Tissue ◽

Fatal Outcome ◽

Anaerobic Bacteria ◽

Tissue Infection ◽

Life Threatening ◽

Staphylococcus Spp

Necrotizing fasciitis (NF) is a serious and potentially life threatening soft tissue infection, usually caused by different types of bacteria such as group A streptococcus, staphylococcus spp. (type 1 infection) or mixed infection by aerobic and anaerobic bacteria (type 2 infection). Usually, the infection arises from skin injury, in injections or surgical procedures and effects the fascia as well as the subcutaneous tissue. Overwhelming progression and difficulties in diagnosing are very common. Mortality rate is up to 100% depending on the type of soft tissue infection and did not markedly decrease in the past decades [1]. Here we present a case of NF with fatal outcome following colonoscopy, which was primarily suspected to be a post polypectomy syndrome.

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The study of the prognostic outcome of necrotizing fasciitis patients with and without diabetes mellitus

International Surgery Journal ◽

10.18203/2349-2902.isj20210364 ◽

2021 ◽

Vol 8 (2) ◽

pp. 563

Author(s):

Navjot Kaur ◽

Seema Mittal ◽

Sudershan Kapoor ◽

Arun Gupta

Keyword(s):

Diabetes Mellitus ◽

Early Diagnosis ◽

Necrotizing Fasciitis ◽

Subcutaneous Tissue ◽

Morbidity And Mortality ◽

Deep Fascia ◽

Superficial Fascia ◽

Cross Sectional ◽

Prognostic Outcome ◽

Aggressive Debridement

Background: Necrotizing fasciitis is highly lethal infection. It can be defined as infection of any layers within the soft tissue compartment (dermis, subcutaneous tissue, superficial fascia, deep fascia or muscle). Early diagnosis and management with identification of co morbidities and treating them brings down the morbidity and mortality rate. To make a full assessment of the cause, all patients require a detailed history, examination and, investigations.Methods: This is a cross sectional comparative study of 50 patients having symptoms of necrotizing fasciitis to be divided into two groups of 25 patients each where one group is having diabetes mellitus and other group without diabetes mellitus.Results: Diabetes mellitus patients have more morbidity and mortality in term of more days of hospital stay, rate of amputations and number of debridements. Early diagnosis and early aggressive debridement is the mainstay of management. Aggressive surgical debridement at initial stages of presentation can halt the clinical process and patient can have better prognosis. In neglected diabetic patient’s debridement alone is not sufficient and amputation may be required in some cases. Conclusions: Early diagnosis and aggressive debridement in necrotizing fasciitis patients results in better outcomes.

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Odontogenic cervico-facial necrotizing fasciitis. A case report

CES Odontología ◽

10.21615/cesodon.33.1.4 ◽

2020 ◽

Vol 33 (1) ◽

pp. 30-36

Author(s):

Klinger de Souza Amorim ◽

Anne Caroline Gercina Carvalho Dantas ◽

Allen Matheus da Silva Nascimento ◽

Andrea Gomes Dellovo ◽

Ricardo Luiz Cavalcanti De Albuquerque Júnior ◽

...

Keyword(s):

Necrotizing Fasciitis ◽

Soft Tissues ◽

Subcutaneous Tissue ◽

Superficial Fascia ◽

Facial Region ◽

Gas Formation ◽

Systemic Antibiotic Therapy ◽

Subcutaneous Tissues ◽

Extensive Debridement ◽

Extensive Necrosis

Necrotizing fasciitis is characterized as a subset of aggressive infections of the skin and soft tissues that cause necrosis of the muscular fascia and subcutaneous tissues. It has a polymicrobial origin and presents an extensive necrosis that exhibits gas formation in the subcutaneous tissue and superficial fascia. The management of infected tissues requires rapid diagnosis, immediate surgical intervention accompanied by extensive debridement and systemic antibiotic therapy. The aim of this paper is to relate a case of an odontogenic necrotizing fasciitis of the cervico-facial region emphasizing the importance of early diagnosis and treatment.

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Vibrio parahaemolyticusInduced Necrotizing Fasciitis: An Atypical Organism Causing an Unusual Presentation

Case Reports in Infectious Diseases ◽

10.1155/2013/216854 ◽

2013 ◽

Vol 2013 ◽

pp. 1-4 ◽

Cited By ~ 2

Author(s):

Asim Ahmad ◽

Lisa Brumble ◽

Michael Maniaci

Keyword(s):

Bacterial Infection ◽

Necrotizing Fasciitis ◽

Vibrio Parahaemolyticus ◽

Subcutaneous Tissue ◽

Treatment Strategies ◽

Disease Process ◽

Initial Presentation ◽

Unusual Presentation ◽

Life Threatening

Background necrotizing fasciitis (NF) represents a life-threatening bacterial infection characterized by a rapid necrosis of deep subcutaneous tissue and facia underlying the skin. Despite its lethal nature, NF occurs infrequently, leaving many physicians unfamiliar with the disease process, common pathogens, and treatment strategies. Here we present a case of NF caused by an unlikely organism,Vibrio parahaemolyticus. We highlight the innocuous nature of initial presentation and the potentially devastating sequela.

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Metastatic Calcinosis of Gastric Mucosa

Journal of Investigative Medicine High Impact Case Reports ◽

10.1177/2324709620940482 ◽

2020 ◽

Vol 8 ◽

pp. 232470962094048

Author(s):

Vatsalya Kosuru ◽

Azeem Mohammed ◽

Rajan Kapoor ◽

Khushali Jhaveri ◽

Vidya Medepalli ◽

...

Keyword(s):

Soft Tissues ◽

Clinical Symptoms ◽

Epigastric Pain ◽

Incidental Finding ◽

Subcutaneous Tissue ◽

Calcinosis Cutis ◽

Calcium Salts ◽

Metastatic Calcification ◽

Gi Symptoms ◽

Life Threatening

Calcinosis cutis refers to the deposition of calcium salts in the cutaneous and subcutaneous tissue and is frequently associated with inflammation. Gastric calcinosis can be classified into metastatic, dystrophic, and idiopathic; metastatic calcinosis is the most common type. In metastatic calcification, calcium salts are deposited in normal soft tissues in the setting of altered metabolism of serum calcium and phosphorus and is a rare and serious complication of chronic renal failure. The important factors contributing to the development of metastatic calcinosis are hypercalcemia, hyperphosphatemia, and an elevated calcium-phosphate product. The most striking feature of this diagnosis is the calcification around the large joints. While it mostly involves dermis of small and medium-sized vessels, it can rarely affect the mucosal layers of the gastrointestinal (GI) tract. Calcinosis presents as a marker for the presence of calcifications in other organs, such as heart or lung, which can be life-threatening. Patients rarely present with clinical symptoms of GI upset, dyspepsia, or epigastric pain that are attributed to calcinosis. If patients present with GI symptoms, infectious causes remain to be higher on the differential. We present a case of incidental finding of gastric mucosal calcinosis during the workup and treatment of dysphagia.

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Necrotizing Fasciitis: a Clinical Case and a Review of the Literature

Serbian Journal of Dermatology and Venerology ◽

10.2478/sjdv-2020-0017 ◽

2020 ◽

Vol 12 (4) ◽

pp. 141-146

Author(s):

Ivanka Danchova Temelkova ◽

Yordan Stoyanov Milev ◽

Zhasmina Krasimirova Garkova ◽

Tsveta Ivanova Kalinova ◽

Zhenya Krasimirova Dimitrova ◽

...

Keyword(s):

Soft Tissue ◽

Early Diagnosis ◽

Necrotizing Fasciitis ◽

Severe Pain ◽

Clinical Case ◽

Subcutaneous Tissue ◽

Good Prognosis ◽

Review Of The Literature ◽

Fatal Course ◽

Life Threatening

Abstract Necrotizing fasciitis is a soft tissue, life-threatening infection with a fulminant and often fatal course. Early diagnosis is usually delayed as the onset of the disease is often masked in the form of erysipelas or cellulite. The condition is characterized by necrosis of the skin, subcutaneous tissue and underlying fascia. We describe a case of a 42-year-old man with a complaint of erythema, fever and severe pain in his right leg 4 days before hospitalization. The patient was admitted and treated with a diagnosis of erysipelas. A few hours after admission, in connection with a drastic deterioration in the general condition and dermatological status, he was transferred to a purulentseptic ward with a fulminant picture of necrotizing fasciitis. Debridement and fasciotomy were performed successfully and timely. Good prognosis and survival in patients with NF correlate directly with the complex of measures. Appropriate antibiotics and intensive general support avoid massive systemic diffusion. Early and adequate surgical debridement and fasciotomy are associated with improved survival.

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Necrotizing Fasciitis of the Cheek: A Case Report

Acta Facultatis Medicae Naissensis ◽

10.1515/afmnai-2017-0030 ◽

2017 ◽

Vol 34 (3) ◽

pp. 247-252

Author(s):

Vojkan Lazić ◽

Dragan Krasić ◽

Miloš Trajković ◽

Miloš Stojanović ◽

Nikola Živković ◽

...

Keyword(s):

Escherichia Coli ◽

Staphylococcus Aureus ◽

Necrotizing Fasciitis ◽

Soft Tissues ◽

Early Recognition ◽

The Body ◽

Left Cheek ◽

Full Thickness ◽

Life Threatening ◽

Subcutaneous Tissues

SummaryThe term necrotizing fasciitis (NF) was first used by Wilson in 1952, who described this rare, however, progressive infection that primarily affects the fascia and subcutaneous tissues. Necrotizing fasciitis may affect any part of the body; however, it usually appears on the extremities. The most common microorganisms isolated in NF areStaphylococcus aureus, groupA Streptococci, andEscherichia Coli.We are presenting the case of a sixty-seven-year old woman, who was admitted for the perforation of painful edema of the left cheek. Clinical examination of the anterior two-thirds of the left cheek revealed a defect of the full thickness of the skin, 3×4 cm in size. During the patient’s hospitalization she was treated by parenterally administered broad-spectrum antibiotics, necrotomy, fasciotomy of the cheek and the extraction of the remaining roots in the 3rdand 4thquadrant.Necrotic fasciitis is a rare, rapidly progressive infection of soft tissues, which, if untimely diagnosed and treated, may be life-threatening. The prognosis of treatment depends on the early recognition of the disease. It is treated with aggressive surgical debridement followed by antibiotic therapy.

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