https://doi.org/10.4081/ijwc.2021.60
Necrotizing fasciitis: A case report and a review of the literature
Submitted: March 19, 2020
Accepted: March 30, 2021
Published: July 30, 2021
Accepted: March 30, 2021
Abstract Views: 1484
PDF: 130
PDF (Italiano): 196
PDF (Italiano): 196
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Necrotizing Fasciitis (NF) is a soft tissue infection characterized by extensive necrosis of subcutaneous fat, neurovascular structures and fascia. The characteristic of this case was aggression and rapid extension of the disease. A 59-years-old woman was observed in a very serious condition, with fever and a large necrotic area that smelled of the right inguinal-femoral region in extension to the thigh. No history of illness. Obesity. Diagnosis may be delayed due to minimal initial cutaneous cellulite. A delay in diagnosis can lead to the progression of the disease shown by shock, multiple organ failure and, ultimately, death. Computed tomography and Magnetic Resonance Imaging could be useful in cases where the signs are equivocal or the diagnosis is in doubt. A detailed review of the literature is presented and the current treatment modalities are described. In this case, the aggressive surgical debridement, the complete medical management of sepsis and comorbidities and the timely closure of the wound by dermo-epidermal grafting were essential for a positive result. NF is an uncommon life-threatening soft tissue infection, which spreads rapidly and progressively along the deep fascia. The prognosis depends on accurate diagnosis and immediate treatment.
Wong CH, Chang HC, Pasupathy S, et al. Necrotizing fasciitis: clinical presentation, microbiology, and determinants of mortality. J Bone Joint Surg Am 2003;85:1454-60.
DOI: https://doi.org/10.2106/00004623-200308000-00005
Wilson B. Necrotizing fasciitis. Am Surg 1952;18:416-31.
McHenry CR, Piotrowski JJ, Petrinic D, Malangoni MA. Determinants of mortality for necrotizing soft-tissue infections. Ann Surg 1995;221:558-63.
DOI: https://doi.org/10.1097/00000658-199505000-00013
Elliott DC, Kufera JA, Myers RA. Necrotizing soft tissue infections. Risk factors for mortality and strategies for management. Ann Surg 1996;224:672-83.
DOI: https://doi.org/10.1097/00000658-199611000-00011
Cheng NC, Tai HC, Tang YB, et al. Necrotising fasciitis: clinical features in patients with liver cirrhosis. Br J Plast Surg 2005;58:702-7.
DOI: https://doi.org/10.1016/j.bjps.2005.01.019
Yu KH, Ho HH, Chen JY, Luo SF. Gout complicated with necrotizing fasciitis - report of 15 cases. Rheumatology (Oxford) 2004;43:518-21.
DOI: https://doi.org/10.1093/rheumatology/keh097
Swartz MN. Cellulitis and subcutaneous tissue infections. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and practice of infectious diseases. 6th ed. PhIladelphia: Elsevier Churchill Livingstone; 2005: p. 1172-94.
Childers BJ, Potyondy LD, Nachreiner R, et al. Necrotizing fasciitis: a fourteen-year retrospective study of 163 consecutive patients. Am Surg 2002;68:109-16.
Taviloglu K, Cabioglu N, Cagatay A, et al. Idiopathic necrotizing fasciitis: risk factors and strategies for management. Am Surg 2005;71:315-20.
DOI: https://doi.org/10.1177/000313480507100408
Liu YM, Chi CY, Ho MW, et al. Microbiology and factors affecting mortality in necrotizing fasciitis. J Microbiol Immunol Infect 2005;38:430-5.
Golger A, Ching S, Goldsmith CH, et al. Mortality in patients with necrotizing fasciitis. Plast Reconstr Surg 2007;119:1803-7.
Meisel M, Schultz-Coulon HJ. Lebensbedrohliche nekrotisierende Fasciitis colli durch Serratia marcescens [Life-threatening necrotizing fasciitis colli caused by Serratia marcescens]. HNO 2009;57:1071-4.
DOI: https://doi.org/10.1007/s00106-007-1592-y
Tsai YH, Hsu RW, Huang TJ, et al. Necrotizing soft-tissue infections and sepsis caused by Vibrio vulnificus compared with those caused by Aeromonas species. J Bone Joint Surg Am 2007;89:631-6.
DOI: https://doi.org/10.2106/JBJS.F.00580
Costanzo M, Caruso LAM, Condorelli F, et al. Necroting fasciitis case report. Ann Ital Chir 2008;79:299-302.
Jones J. Investigation upon the nature, causes and treatment of hospital gangrene as prevailed in the Confederate armies 1861–1865. In: United States Sanitary Commission, editor. Surgical memoirs of the War of the Rebellion. New York, NY: Hurd and Houghton; 1871: p. 142-580.
Wang YS, Wong CH, Tay YK. Staging of necrotising fasciitis based on the evolving cutaneous features. Int J Dermatol2007;46:1036-41.
DOI: https://doi.org/10.1111/j.1365-4632.2007.03201.x
Seal DV. Necrotizing fasciitis. Curr Opin Infect Dis2001;14:127-32.
DOI: https://doi.org/10.1097/00001432-200104000-00003
Puvanendran R, Chan J, Huey M, Pasupathy S. Necrotizing fasciitis. Can Fam Physician 2009; 55: 981–7.
Fustes-Morales A, Gutierrez-Castrellon P, Duran-Mckinster C, et al. Necrotizing fasciitis: report of 39 paediatric cases. Arch Dermatol2002;138:893-9.
DOI: https://doi.org/10.1001/archderm.138.7.893
Brogan TV, Nizet V, Waldhausen JH, et akl. Group A streptococcal necrotizing fasciitis complicating primary varicella: a series of fourteen patients. Pediatr Infect Dis J1995;14:588-94.
DOI: https://doi.org/10.1097/00006454-199507000-00007
Golger A, Ching S, Goldsmith CH, et al. Mortality in patients with necrotizing fasciitis. Plast Reconstr Surg2007;119:1803-7.
DOI: https://doi.org/10.1097/01.prs.0000259040.71478.27
Hill MK, Sanders CV. Necrotizing and gangrenous soft tissue infections. In: Sanders CV, Nesbitt LT Jr, editors. The skin and infection: a color atlas and text. Baltimore, MD: Lipincott, Williams & Wilkins; 1995: p. 62-75.
Green RJ, Dafoe DC, Raffi n TA. Necrotizing fasciitis. Chest1996;110:219-29.
DOI: https://doi.org/10.1378/chest.110.1.219
Hsiao CT, Lin LJ, Shiao CJ, et al. Hemorrhagic bullae are not only skin
deep. Am J Emerg Med2008;26:316-9.
Dufel S, Martino M. Simple cellulitis or a more serious infection?J Fam Pract2006;55:396-400.
Wong CH, Wang YS. The diagnosis of necrotizing fasciitis. Curr Opin Infect Dis 2005;18:101-6.
DOI: https://doi.org/10.1097/01.qco.0000160896.74492.ea
Wong CH, Wang TS. What is subacute necrotising fasciitis? A proposed clinical
diagnostic criteria. J Infect 2006;52:415-9.
DOI: https://doi.org/10.1016/j.jinf.2005.08.018
Jarrett P, Rademaker M, Duffi ll M. The clinical spectrum of necrotising fasciitis. A review of 15 cases. Aust N Z J Med1997;27:29-34.
DOI: https://doi.org/10.1111/j.1445-5994.1997.tb00910.x
Lim YJ, Yong FC, Wong CH, Tan AB. Necrotising fasciitis and traditional medical therapy—a dangerous liaison. Ann Acad Med Singapore2006;35:270-3.
Wyoski MG, Santora TA, Shah RM, Friedman AC. Necrotizing fasciitis: CT characteristics. Radiology1997;203:859-63.
DOI: https://doi.org/10.1148/radiology.203.3.9169717
Riseman JA, Zamboni WA, Curtis A, et al. Hyperbaric oxygen therapy for necrotizing fasciitis reduces mortality and the need for debridements. Surgery1990;108:847-50.
Jallali N, Withey S, Butler PE. Hyperbaric oxygen as adjuvant therapy in the management of necrotizing fasciitis. Am J Surg2005;189:462-6.
DOI: https://doi.org/10.1016/j.amjsurg.2005.01.012
Health Protection Agency, Group A Streptococcus Working Group. Interim UK guidelines for management of close community contacts of invasive group A streptococcal disease. Commun Dis Public Health2004;7:354-61.
How to Cite
Petracca, G., Zappia, F., & Maccarone , G. (2021). Necrotizing fasciitis: A case report and a review of the literature. Italian Journal of Wound Care, 5(2). https://doi.org/10.4081/ijwc.2021.60
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.
Similar Articles
- Aurora Parodi, Valeria Maria Messina, Manuela Martolini, Shpresa Haxhiaj, Emanuele Claudio Cozzani, Update on the management and treatment of patients with chronic skin lesions , Italian Journal of Wound Care: Vol. 5 No. 2 (2021)
- Romina Corgiat-Loia, Lucia Pavignano, Marcella Vargiu, Laura Perono Minino, Giovanna Capace, Fabrizia Cogo, Lucia Carlino, Chiara Mangolini, Marzia Soave, Eraldo Personettaz, Enrica Bertotti, Fabrizio Aprà , Carla Varola, Cristina Amato, Eleonora Aloi, Looking beyond...a path started in ASL TO4 for the treatment of chronic skin lesions , Italian Journal of Wound Care: Vol. 2 No. 2 (2018)
- Matteo Bucalossi, Fabrizio Mariani, Autologous peripheral blood mononuclear cells from selective filtration for treatment of chronic lower limb lesions: Results at 4 years , Italian Journal of Wound Care: Vol. 5 No. 2 (2021)
- Sabrin Abd el khalek, Ersilia Balduzzi, Graziella Costamagna, Alexandra Donascimento, Fabrizio Lorenzo Luca Martin, Maddalena Stuardi, Salvatore Piazza, Experience of the vulnology team during COVID-19 period , Italian Journal of Wound Care: Vol. 7 No. 3 (2023)
- Carla Pezzuto, Nadia Felisi, Nadia Crispini, Ilaria Rosso, Use of photobiomodulation with blue light in the treatment of ulcers of various etiology in spinal cord injured patients: a case series , Italian Journal of Wound Care: Vol. 7 No. 2 (2023)
- Angela Peghetti, Diletta Olivari, Silvia Tedesco, Andrea Bellingeri, Marino Ciliberti, Antonio Di Lonardo, Corrado M. Durante, Antonino Grasso, Elia Ricci, Alessandro Scalise, Giovanni Pomponio, Prontosan®solution and Prontosan®Debridement Pad in the treatment of different types of cutaneous wounds: expert-based statements, case series and review of the literature , Italian Journal of Wound Care: Vol. 3 No. 2 (2019)
- Alessandra Chiossi, Conversation Mapâ„¢: a tool for the education of the caregiver on the prevention of pressure ulcers , Italian Journal of Wound Care: Vol. 2 No. 3 (2018)
- Elisabetta Sardone, Elena Toma, Learning survey: assessment and management of the patient with wounds , Italian Journal of Wound Care: Vol. 2 No. 1 (2018)
- Patrizia D'Incecco, Management of painful and potentially infected skin lesions: Transversal activities of community and family nursing , Italian Journal of Wound Care: Vol. 6 No. 2 (2022)
- Fabrizio Moffa, Alberico Balbiano da Colcavagno, Elia Ricci, Use of adipose tissue stem cells in chronic skin lesions: clinical experience , Italian Journal of Wound Care: Vol. 2 No. 2 (2018)
You may also start an advanced similarity search for this article.
