Background: Necrotizing fasciitis (NF) is a uncommon and serious infection involving the skin and subcutaneous tissues of lower and upper limbs, perineal area (Fournier’s gangrene), and the abdominal wall with high morbidity and mortality. Early diagnosis and aggressive treatment can reduce the mortality rate of NF. The objectives of this study are to study the etiolopathological, microbiological factors determining the outcome of necrotizing fasciitis.Methods: It is prospective study and was conducted in JSS Medical College and Hospital in October 2008 to October 2010. Total 50 patients diagnosed with necrotizing fasciitis were admitted to JSS Medical College and Hospital. Demographic data, type of co morbidities, site of infection, clinical features with microbiology and laboratory results, and outcomes of patients were analyzed.Results: Out of 50 patients there were 42 males and 8 females. Highest number of cases was found in the age group of 65-74 years among males, 55-64 years among females. The commonest site in the present study is lower limbs (74%). Diabetes mellitus was the commonest (76%) co morbidity. Beta hemolytic streptococci 22 (44%) was the highest to be isolated. In type I and Coagulase positive staphylococci 18 (36%) was the commonest organism isolated in type II necrotizing fasciitis. The significant risk factors were gender, comorbidties, hospital length of stay, and albumin level, leucocytosis, anemia, hypoalbumenia, low serum ferritin levels increase blood sugar levels. The mortality was 12% (8 patients).Conclusions: Patients with advance age, co-morbid conditions like diabetes mellitus, hypertension, peripheral vascular disease, osteomyelitis had high unexplained susceptibility to the disease and with a higher incidence in males. Thus, early recognition with a high index of clinical suspicion would definitely reduce both morbidity and mortality. It has gross morbidity and mortality if not treated in its early stages. Leucocytosis, anemia, hypoalbumenia, low serum ferritin levels, increase blood sugar levels were consistent findings seen in majority of the patients which resulted in increased morbidity.
Low serum osteocalcin levels are associated with the presence of diabetes mellitus in glucocorticoid treated patients
