scholarly journals Necrotizing Fasciitis of Thoracic and Abdominal Wall with Emphysematous Pyelonephritis and Retroperitoneal Abscess

2018 ◽  
Vol 8 ◽  
pp. 7 ◽  
Author(s):  
Sanjay Mhalasakant Khaladkar ◽  
Kunaal Mahesh Jain ◽  
Rajesh Kuber ◽  
Sidappa Gandage
Keyword(s):  
Diabetes Mellitus ◽  
Necrotizing Fasciitis ◽  
Abdominal Wall ◽  
Early Recognition ◽  
Subcutaneous Tissue ◽  
Left Kidney ◽  
Gas Production ◽  
Retroperitoneal Abscess ◽  
Emphysematous Pyelonephritis ◽  
Thoracic And Abdominal

Emphysematous pyelonephritis is a life-threatening severe form of pyelonephritis usually occurring in patients with diabetes mellitus with or without obstructive uropathies in whom there is necrotizing infection leading to the gas production of an unclear mechanism involving the renal parenchyma and the collecting system. Necrotizing fasciitis is characterized by progressive necrosis of fat and fascia due to deep-seated infection of subcutaneous tissue. It has a fulminant course with considerable mortality. Diabetes Mellitus is a common predisposing factor. The combined occurrence of emphysematous pyelonephritis and necrotizing fasciitis is extremely unusual. Early recognition and management is mandatory to avoid mortality. We report a case of a 53-year-old female, a known case of Type II diabetes mellitus, who presented with necrotizing fasciitis of thoracic and abdominal wall with emphysematous pyelonephritis in the left kidney with a retroperitoneal abscess.

Early recognition of neonatal abdominal wall necrotizing fasciitis

1994 ◽  
Vol 167 (5) ◽  
pp. 481-484 ◽  
Author(s):  
Robert S. Sawin ◽  
Robert T. Schaller ◽  
David Tapper ◽  
Alan Morgan ◽  
John Cahill
Keyword(s):  
Necrotizing Fasciitis ◽  
Abdominal Wall ◽  
Early Recognition

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 The clinical efficacy of laboratory risk indicator for necrotizing fascitis score in early diagnosis of patients with necrotizing fascitis

2021 ◽  
Vol 8 (7) ◽  
pp. 2133
Author(s):  
Murakonda Sowmya Chowdary ◽  
Srinivasan D. ◽  
Sreeramulu P. N. ◽  
Tejaswini M. Pawar ◽  
Krishna Prasad K.
Keyword(s):  
High Risk ◽  
Mortality Rate ◽  
Necrotizing Fasciitis ◽  
Early Recognition ◽  
Subcutaneous Tissue ◽  
Lower Limbs ◽  
Risk Indicator ◽  
Icu Stay ◽  
Necrotizing Fascitis ◽  
Lrinec Score

Background: Necrotizing fasciitis is a rare, rapidly progressive infection which causes extensive necrosis of the fascia and subcutaneous tissue. Early recognition and debridement are major prognostic determinants, and delay has been shown to increase mortality rate. We describe a novel, simple, and objective scoring system, the laboratory risk indicator for necrotizing fasciitis (LRINEC) score, based on routine laboratory investigations readily available at most centres, that can help to distinguish necrotizing fasciitis (nec fasc) from severe cellulitis or abscess.Methods: We performed a single centre, retrospective, all patients treated at the RLJ Hospital for necrotizing fasciitis between January 2017 and December 2019 were included in this study. The outcome of the study was based on comparing LRINEC score and Wang and Wong staging, which is useful to detect necrotizing fasciitis severity.Results: In our study, males were predominantly affected more common in lower limbs followed by perineum and abdominal wall in their fifties with diabetes mellitus and hypertension as dominant co-morbid diseases. In the study among subjects with high risk score, 83.3% required ICU stay, among subjects with moderate risk, 16.7% required ICU stay and among subjects with low risk, 12.5% required ICU stay.Conclusions: All patients with higher LRINEC scores and who were classified as ‘high risk’ in Wang and Wong classification required ICU stay and significant association with mortality rate.

scholarly journals Necrotizing Fasciitis Complicating Pregnancy: A Case Report and Literature Review

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Marinos Nikolaou ◽  
Petros Zampakis ◽  
Vasiliki Vervita ◽  
Konstantinos Almaloglou ◽  
Georgios Adonakis ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Necrotizing Fasciitis ◽  
Subcutaneous Tissue ◽  
Skin Grafting ◽  
Skin Defect ◽  
Surgical Infection ◽  
Left Lower Extremity ◽  
Split Thickness Skin Grafting ◽  
Necrotizing Soft Tissue Infections ◽  
Magnetic Resonance Imaging Mri

Necrotizing fasciitis is a rare, life-threatening surgical infection in pregnancy with high rates of morbidity and mortality. A 15-year-old primigravid woman, at 28 weeks of gestation with no significant previous medical history, was admitted to our hospital complaining of severe left lower extremity pain and high fever the last 72 hours. During clinical examination, she had a swollen, erythematous and tender to palpation inflamed skin over the medial aspect of the upper thigh without any evidence of injury. Incision drainage was performed immediately and she received broad spectrum antibiotics. During initial laboratory examinations, diabetes mellitus was diagnosed. There was no clinical improvement over the following days. Magnetic resonance imaging (MRI) revealed subcutaneous tissue inflammation and edema of infected tissues confirming the disease entity. Multidisciplinary therapy with immediate aggressive surgical debridement of necrotic tissues, multiple antibiotics, and intensive care monitoring was performed successfully. The patient’s postoperative course was uncomplicated and skin defect was closed with split thickness skin grafting. Our case emphasized the potential immunosuppressive role of pregnancy state in conjunction with diabetes mellitus in the development of severe necrotizing soft tissue infections.

scholarly journals Emphysematous pyelonephritis: non surgical treatment approach

2015 ◽  
Vol 14 (3) ◽  
pp. 305-307
Author(s):  
Kiran Kumar Singal ◽  
Neerja Singal ◽  
Bhaskar Gupta ◽  
Karun Puran Bhatti ◽  
Abhinav Gupta
Keyword(s):  
Diabetes Mellitus ◽  
Left Kidney ◽  
Medical Science ◽  
Severe Infection ◽  
Lumbar Region ◽  
Emphysematous Pyelonephritis ◽  
Patients With Diabetes ◽  
Life Threatening ◽  
High Doses

Emphysematous pyelonephritis is a severe infection characterized by the presence of gas within the renal parenchyma tissues. It is a life threatening complication of bacterial interstitial nephritis, and it mainly occurs in patients with diabetes mellitus. We report a case of a 37 year old female who complained of fever and pain in left lumbar region on admission. Her past medical history included uncontrolled type 2 diabetes mellitus. On USG (ultrasonography), left kidney swollen and show echogenic linear specs with dirty shadowing suggestive of air in pelvicalyceal system (PCS). She was treated with intensive antibiotic therapy in high doses. On repeat USG there was marked reduction in air shadow in kidney and patient improved clinically.Bangladesh Journal of Medical Science Vol.14(3) 2015 p.305-307

scholarly journals Clinicopathology study of necrotizing fasciitis with special reference to Fournier’s gangrene

2017 ◽  
Vol 4 (10) ◽  
pp. 3492
Author(s):  
Navjot Brar ◽  
Jatinder Singh Dhaliwal ◽  
Amanjot Singh ◽  
Rajbir Bajwa
Keyword(s):  
Diabetes Mellitus ◽  
Necrotizing Fasciitis ◽  
Special Reference ◽  
Subcutaneous Tissue ◽  
Fournier’S Gangrene ◽  
Polymicrobial Infection ◽  
Personal Hygiene ◽  
Fournier's Gangrene ◽  
Predisposing Factor ◽  
Cross Sectional

Background: Necrotizing fasciitis including Fournier’s gangrene is an uncommon, critically serious infection of the subcutaneous tissue and fascia with relative sparing of the skin and muscle. Despite modern supportive measures, the reported mortality rate still is high and this is due to part to the aggressive nature of the infection. The present study was performed upon 50 patients to study clinicopathology of necrotizing fasciitis with special reference to Fournier’s gangrene. Methods: This cross-sectional study was conducted in Surgery ward of SGRD Hospital, for a period of 1 year (1st January 2015 to 31st December 2015). The performa filled for patients with necrotizing fasciitis was designed on the basis of NICE guidelines and details like history, examination, general survey, local examination, systemic examination and investigations, statistical analysis of data done. Results: Necrotizing fasciitis, though it is found at any age but is a disease of middle and old aged adults in this part of the world, being commonest in the 4th, 5th, 6th decades of life and is more common in males. The disease is more common in people with low socio-economic groups with poor personal hygiene, diabetes mellitus and history of drug addiction. Trauma is the most common predisposing factor for the necrotizing fasciitis as a whole whereas idiopathic cause is the most common cause in cases of Fournier’s gangrene. Polymicrobial infection is the most common variety, where in E. coli, Streptococcus, Bacteroids are most commonly isolated. Regarding monobacterial infection streptococcus being the most common. Conclusion: Current study showed increased frequency of necrotizing fasciitis in people aged above 40 years. Diabetes mellitus and other premorbid conditions increase the risk of mortality. Polymicrobial infection in combination of Escherichia coli, Streptococcus, Pseudomonas, Bacteroids and Staphylococcus were the most commonly found. Early debridement, parenteral combined antibiotic and supportive measure formed the basis of treatment. Septicemia was a common complication which was often cause death.

scholarly journals Validation of LRINEC (Laboratory Risk Indicators for Diagnosis of Necrotizing Fasciitis) Scoring System for the Diagnosis of Necrotizing Fasciitis

2020 ◽  
Vol 23 (2) ◽  
pp. 75-80
Author(s):  
Md Nur Alam Mohim ◽  
MA Hashem Bhuiya ◽  
AZM Mahfuzur Rahman ◽  
Md Mahmudul Islam ◽  
Masfique Ahmed Bhuiya
Keyword(s):  
Soft Tissue ◽  
Necrotizing Fasciitis ◽  
Early Recognition ◽  
Subcutaneous Tissue ◽  
Risk Indicators ◽  
Soft Tissue Infections ◽  
Predictive Values ◽  
Lrinec Score ◽  
Surgery Department ◽  
Severe Soft Tissue

Background : Necrotizing fasciitis (NF) is a rare but potentially fatal infection involving the subcutaneous tissue and fascia. Different classifications and terminology has been used in NF based on affected anatomy, microbial cause and depth of infection. Clinical scores like the laboratory risk indicators for NF (LRINEC) scores are available to help diagnose NF and differentiate it from other skin and soft tissue infections. Methods : A total of 100 patients were included in the study between January 2014 to June 2014. This prospective study was done on patients admitted in surgery department of DMCH with symptoms suggestive of soft tissue infections during the study period. Results : Mean age was found 46.5(±13.8) years in severe cellulitis and 50.9(±9.8) years in necroting fasciitis (p>0.05). Male were predominant (60%). 80% of NF had DM. The validation test for LRINEC score e”6 vs necrotizing fasciitis had sensitivity of 66%, specificity 84%, accuracy 75%, positive and negative predictive values were 80.49% and 71.19% respectively. Mortality of NF was 6%. Conclusion : The LRINEC score is an impressive diagnostic tool to distinguish necrotizing fasciitis from other severe soft tissue infections, but it is not useful for early recognition of necrotizing fasciitis. Journal of Surgical Sciences (2019) Vol. 23(2): 75-80

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