scholarly journals Odontogenic cervico-facial necrotizing fasciitis. A case report

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.

scholarly journals Concurrent Pseudomonas Periorbital Necrotizing Fasciitis and Endophthalmitis: A Case Report and Literature Review

Pathogens ◽  
2021 ◽  
Vol 10 (7) ◽  
pp. 854
Author(s):  
Yu-Kuei Lee ◽  
Chun-Chieh Lai
Keyword(s):  
Soft Tissue ◽  
Literature Review ◽  
Necrotizing Fasciitis ◽  
Subcutaneous Tissue ◽  
Superficial Fascia ◽  
Upper Eyelid ◽  
Case Presentation ◽  
Phthisis Bulbi ◽  
Eyelid Swelling ◽  
The Rich

(1) Background: Necrotizing fasciitis (NF) is an infection involving the superficial fascia and subcutaneous tissue. Endophthalmitis is an infection within the ocular ball. Herein we report a rare case of concurrent periorbital NF and endophthalmitis, caused by Pseudomonas aeruginosa (PA). We also conducted a literature review related to periorbital PA skin and soft-tissue infections. (2) Case presentation: A 62-year-old male had left upper eyelid swelling and redness; orbital cellulitis was diagnosed. During eyelid debridement, NF with the involvement of the upper Müller’s muscle and levator muscle was noted. The infection soon progressed to scleral ulcers and endophthalmitis. The eye developed phthisis bulbi, despite treatment with intravitreal antibiotics. (3) Conclusions: Immunocompromised individuals are more likely than immunocompetent hosts to be infected by PA. Although periorbital NF is uncommon due to the rich blood supply in the area, the possibility of PA infection should be considered in concurrent periorbital soft-tissue infection and endophthalmitis.

Noma and Necrotizing Fasciitis of the Face and Neck

2021 ◽  
Author(s):  
Lauren E. Miller ◽  
David A. Shaye
Keyword(s):  
Soft Tissue ◽  
Necrotizing Fasciitis ◽  
Head And Neck ◽  
Subcutaneous Tissue ◽  
Neck Region ◽  
Superficial Fascia ◽  
Soft Tissue Infections ◽  
Head And Neck Region ◽  
Necrotizing Soft Tissue Infections ◽  
The Face

AbstractNecrotizing fasciitis (NF) is part of the class of necrotizing soft tissue infections characterized by rapid fascial spread and necrosis of the skin, subcutaneous tissue, and superficial fascia. If left untreated, NF can rapidly deteriorate into multiorgan shock and systemic failure. NF most commonly infects the trunk and lower extremities, although it can sometimes present in the head and neck region. This review provides an overview of NF as it relates specifically to the head and neck region, including its associated clinical features and options for treatment. Noma, a related but relatively unknown disease, is then described along with its relationship with severe poverty.

scholarly journals Pyelonephritis can be a source of a life threatening necrotizing myofasciitis

2014 ◽  
Vol 8 (5-6) ◽  
pp. 462
Author(s):  
Haytham Kamel ◽  
Mohamed Soliman Edris Awed ◽  
Ahmed Fouad Kotb
Keyword(s):  
Necrotizing Fasciitis ◽  
Adult Male ◽  
Soft Tissues ◽  
Subcutaneous Tissue ◽  
Relevant Literature ◽  
Deep Fascia ◽  
Necrotizing Myositis ◽  
Life Threatening

Necrotizing fasciitis is a progressive, rapidly spreading, inflammatory infection located in deep fascia. It may cause necrosis of skin and subcutaneous tissue and can even result in involvement of adjacent soft tissues such as muscles resulting in necrotizing myositis. We report the case of an adult male presenting with necrotizing myofasciitis secondary to left pyelonephritis. We also review the relevant literature.

scholarly journals Necrotizing Fasciitis in Neonate and Use of Allograft

2019 ◽  
Vol 8 (1) ◽  
pp. 8
Author(s):  
Nitinkumar Borkar ◽  
Phalguni Padhi ◽  
Jiten Kumar Mishra ◽  
Shamendra Anand Sahu ◽  
Debajyoti Mohanty ◽  
...  
Keyword(s):  
Early Diagnosis ◽  
Necrotizing Fasciitis ◽  
Skin Graft ◽  
Subcutaneous Tissue ◽  
Donor Site ◽  
Subcutaneous Fat ◽  
Surgical Debridement ◽  
Split Thickness Skin Graft ◽  
Superficial Fascia ◽  
Thickness Skin

Necrotising fasciitis is a fulminant and rapidly progressive infection of the superficial fascia and subcutaneous tissue. It is rare in newborn. Trunk is the commonest site of involvement in newborns. Early diagnosis and prompt surgical debridement is the preferred treatment. Debridement in NF leads to a large raw area which may not heal by primary intention and may a split thickness skin graft for healing. Presence of minimum subcutaneous fat, loose skin and large raw area at donor site like back in some neonate poses difficulty for harvesting of skin graft. In such neonates allograft make a valuable option temporarily. Herein we report a case of a neonate with NF in whom post debridement raw area was covered with allograft from mother.

scholarly journals Fournier’s gangrene

2016 ◽  
Vol 97 (2) ◽  
pp. 256-261
Author(s):  
A V Prokhorov
Keyword(s):  
Soft Tissues ◽  
Subcutaneous Tissue ◽  
Disease Onset ◽  
Disease Diagnosis ◽  
Fournier’S Gangrene ◽  
Time Interval ◽  
Vacuum Therapy ◽  
Superficial Fascia ◽  
Fournier's Gangrene ◽  
Septic Complications

The review highlights the issues of etiology, pathogenesis, clinical and laboratory picture, radiodiagnosis, treatment and prognosis of fulminant perineum gangrene, or Fournier’s gangrene. According to modern concepts, Fournier’s gangrene is one of the rare forms of necrotizing fasciitis of polymicrobial etiology with a primary lesion of the skin, subcutaneous tissue and superficial fascia of the scrotum, penis, and perineum. Fournier’s gangrene refers to acute surgical diseases of pyonecrotic nature and is characterized by rapid septic course, high mortality, reaching 80%, in spite of the modern antibiotic therapy advances. Over the last decade the Fournier’s gangrene incidence increased in 2.2-6.4 times, due to the increasing number of immunocompromised patients in the population. The disease most often occurs in older men with diabetes, alcoholism and obesity. The Fournier’s gangrene occurrence is preceded by different inflammatory diseases of the colon, urinary organs, scrotum and perineum skin. The disease diagnosis in full-scale stage usually is not difficult. In rare cases, namely in the disease early stages, various radiological methods of investigation, laboratory tests and exploratory surgery with affected soft tissues express biopsy are used with differential diagnosis purposes. The cornerstone in the Fournier’s gangrene treatment is an emergency surgical intervention in combination with a powerful anti-bacterial and anti-shock therapy. To improve the wound healing course and reduce the septic complications risk, new methods of adjuvant treatments such as hyperbaric oxygen therapy and vacuum therapy are used. Hospitalization duration in Fournier’s gangrene is usually lengthy, due to the need to use repeated sanitation necrectomy and reconstructive plastic surgery and are associated with considerable economic costs for treatment. The Fournier’s gangrene prognosis depends on the timing of specialized medical care provision and, above all, on the time interval between the disease onset and surgery performing.

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

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.  

scholarly journals Necrotizing fasciitis in obstetric practice: review of literature and description of own clinical саse

2019 ◽  
pp. 150-155
Author(s):  
V. M. Husiev ◽  
V. M. Astakhov ◽  
S. A. Dubyna
Keyword(s):  
Early Diagnosis ◽  
Necrotizing Fasciitis ◽  
Soft Tissues ◽  
Clinical Symptoms ◽  
Inflammatory Diseases ◽  
Clinical Manifestations ◽  
Fatty Tissue ◽  
Superficial Fascia ◽  
Surgical Infection ◽  
Surgical Infections

Despite the successes of modern medicine, the problem of purulent surgical infection still remains relevant and is one of the unsolved and most debatable in clinical surgery. In the structure of purulent-inflammatory diseases of soft tissues, there are forms of surgical infections that are characterized by progressive necrosis of fascial formations and particular clinical course. They are accompanied by the development of endotoxemia, which further leads to the development of severe sepsis and multiple organ failure. Among generalized surgical infections, necrotizing fasciitis is of particular interest – one of the varieties of a large group of surgical infections of soft tissues, in the pathomorphological basis of which lies the rotten-necrotic lesion of the superficial fascia and subcutaneous fatty tissue. It has various clinical manifestations, the absence of specific signs that make it difficult for clinicians of various specialties to diagnose in time, the development of serious complications and deaths. The basis for the early diagnosis of necrotizing soft tissue infections, therefore, the key to successful treatment of these seriously ill patients, as before, is the timely analysis of anamnestic data and clinical symptoms. The treatment of necrotizing fasciitis is a difficult and complex task, which is explained by the peculiarity of the pathological process, the success of which is determined by early diagnosis and urgent radical surgical intervention. Rarely rare publications on this issue are the cause of the information vacuum and the lack of awareness of the majority of doctors in this pathology, potential for the development of critical states, once again necessitates the imperative informing of narrow specialists, as well as doctors practicing in the outpatient network and hospital level. Тhe article describes the own clinical observation of the fulminant form of necrotising fasciitis diagnosed by autopsy data.

scholarly journals Necrotizing Fasciitis of the Cheek: A Case Report

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.

scholarly journals Necrotizing Fasciitis: A Review of Management Guidelines in a Large Obstetrics and Gynecology Teaching Hospital

1993 ◽  
Vol 1 (1) ◽  
pp. 16-22 ◽  
Author(s):  
C. D. Thompson ◽  
A. L. Brekken ◽  
W. H. Kutteh
Keyword(s):  
Risk Factors ◽  
Soft Tissue ◽  
Necrotizing Fasciitis ◽  
Operating Room ◽  
Teaching Hospital ◽  
Subcutaneous Tissue ◽  
Diabetic Woman ◽  
Wound Complications ◽  
Morbidly Obese ◽  
Superficial Fascia

Necrotizing fasciitis is a severe, life-threatening soft tissue infection that results in rapid and progressive destruction of the superficial fascia and subcutaneous tissue. Because of its varied clinical presentation and bacteriological make-up, it has been labelled with many other names such as acute streptococcal gangrene, gangrenous erysipelas, necrotizing erysipelas, hospital gangrene, and acute dermal gangrene. Although described by Hippocrates and Galen, it has received increasing attention in obstetrical and gynecological literature only within the last 20 years. This review includes two recent cases successfully managed at Parkland Memorial Hospital, Dallas, Texas. The first patient was a 50 year old, morbidly obese, diabetic woman who presented with a small, painful lesion on the vulva. After failing triple antibiotic therapy with ampicillin, clindamycin, and gentamicin, the diagnosis of necrotizing fasciitis of the vulva was made, and she was taken to the operating room for extensive excision. She was discharged home on hospital day 29. The second patient was a 65 year old, obese, diabetic woman with risk factors for atherosclerosis who had a wound separation after an abdominal hysterectomy. Two days later a loss of resistance to probing was noted in the subcutaneous tissue. Necrotizing fasciitis was suspected, and she was taken to the operating room for resection. The patient was discharged home on hospital day 27. The mortality rate after diagnosis of necrotizing fasciitis has been reported to be 30% to 60%. We review the literature and outline the guidelines used in a large Ob/Gyn teaching hospital to minimize the adverse outcome. Lectures on soft-tissue infections are included on a regular basis. The high-risk factors of age over 50, diabetes, and atherosclerosis are emphasized. The need for early diagnosis and surgical treatment within 48 hours is stressed, and any suspicious lesions or wound complications are reported to experienced senior house officers and staff. We use two recent cases to highlight the diagnostic clues and management strategies for this often fatal polymicrobial infection.

scholarly journals Necrotizing Fasciitis: Diagnostic Challenges and Current Practices

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Abhishek Vijayakumar ◽  
Rajeev Pullagura ◽  
Durganna Thimmappa
Keyword(s):  
Soft Tissue ◽  
Early Diagnosis ◽  
Necrotizing Fasciitis ◽  
Subcutaneous Tissue ◽  
Scoring Systems ◽  
Risk Groups ◽  
Deep Fascia ◽  
Superficial Fascia ◽  
Diagnosis And Management ◽  
Necrotizing Soft Tissue Infections

Necrotizing fasciitis or necrotizing soft-tissue infections (NSTIs) are infrequent but highly lethal infections. They can be defined as infections of any of the layers within the soft tissue compartment (dermis, subcutaneous tissue, superficial fascia, deep fascia, or muscle) that are associated with necrotizing changes. At onset, necrotizing fasciitis can be difficult to differentiate from cellulitis and other superficial infections of the skin. In fact, only 15% to 34% of patients with necrotizing fasciitis have an accurate admitting diagnosis. Early diagnosis and management with surgical debridement, antimicrobials, and supportive measures reduce mortality. Even with modern ICU care mortality ranges between 16 and 36%; this is related to delays in diagnosis and comorbidities. Various scoring systems have been developed which help in diagnosis and stratifying patients into risk groups. The present review deals with varied presentation, early diagnosis, and management of necrotizing fasciitis.

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