Family Med Medical News about Fasciitis, Necrotizing

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Necrotizing fasciitis
Canadian Family Physician, 10/14/09

Puvanendran R et al. – Necrotizing fasciitis is a rare but potentially fatal disease; it can occur in all parts of the body, including the oral cavity and the perineum.

Typically, patients who develop type 1 (polymicrobial) necrotizing fasciitis are immunocompromised in some way. However, with the type 2 (monomicrobial) variety, patients are usually immunocompetent with a history of trauma (sometimes minor).
Diagnosis is often delayed because of a paucity of signs and a low index of suspicion.
Necrotizing fasciitis is a clinical diagnosis. Blood tests and imaging, especially magnetic resonance imaging and computed tomography scans, can be helpful but are not diagnostic. Surgical exploration is advised if clinical suspicion is high.
Management includes fluid resuscitation, if indicated, intravenous broad spectrum antibiotics, and early surgical debridement. Increasingly, community–acquired methicillin–resistant Staphylococcus aureus is being identified as the infective agent.

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