RT Book, Section
A1 Ritter, Kathryn
A1 Fitch, Robert Warne
A2 Knoop, Kevin J.
A2 Stack, Lawrence B.
A2 Storrow, Alan B.
A2 Thurman, R. Jason
SR Print(0)
ID 1181043513
T1 Necrotizing Fasciitis
T2 The Atlas of Emergency Medicine, 5e
YR 2021
FD 2021
PB McGraw-Hill
PP New York, NY
SN 9781260134940
LK accessmedicine.mhmedical.com/content.aspx?aid=1181043513
RD 2024/04/24
AB This  uncommon,  severe  infection  involves  the  subcutaneous  soft  tissues,  including  the  superficial  and  deep  fascial  layers.  It  is  usually  seen  in  the  lower  extremities,  abdominal  wall,  and  perianal  or  groin  area.  It  is  commonly  spread  from  a  trauma  site,  surgical  wound,  abscess,  or  decubitus  ulcer.  Alcoholism,  parenteral  drug  abuse,  and  diabetes  are  predisposing  factors.  Pain,  tenderness,  erythema,  swelling,  warmth,  shiny  skin,  lymphangitis,  and  lymphadenitis  are  early  findings.  Later,  there  is  rapid  progression  of  bullae  with  clear  pink  or  purple  fluid  and  cutaneous  necrosis;  the  skin  becomes  anesthetic,  and  subcutaneous  gas  may  be  present.  Systemic  toxicity  may  be  manifest  by  fever,  dehydration,  leukocytosis,  and  frequently  positive  blood  cultures.  Type  I  is  polymicrobial  and  includes  anaerobic  species.  Type  II  includes  group  A  streptococci.