1887
Volume 2009, Issue 1
  • ISSN: 0253-8253
  • EISSN: 2227-0426

Abstract

To analyze the different presentation, types of infection, predisposing factors (particularly diabetes mellitus) of necrotizing fasciitis; a rare potentially fatal rapidly progressing necrotizing infection of subcutaneous tissue and superficialfascia with secondary necrosis of overlying skin, the medical records were reviewed retrospectively of 94 patients (71 male; 23 female) admitted to the surgical intensive care unit of Hamad General Hospital, Qatar, between January 1995 and February 2005. Fifty-three patients (56.4%) were diabetic with a mean age of 55 years compared with 40.2 years in non-diabetic patients. Type 1 necrotizing fasciitis, especially of the perineal and genital regions, was more common in diabetic patients whereas type 2 necrotizing fasciitis, especially of torso and upper limbs, was more common in non-diabetic patients. Overall 63.4% of cases were type 2 necrotizing fasciitis. E.coli was the most common bacterium isolated from necrotic tissue of diabetic patients and streptococci were the most common cause of necrotizing fasciitis in non-diabetic patients. Fifteen (16%) patients died but there was no significant difference in mortality between the groups, eight (15.1%) diabetic, seven (17.1%) non-diabetic, although diabetic patients were significantly older.

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2009-05-01
2024-03-29
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References

  1. Helmy AS, Salah MA, Nawara HA, et al., Life threatening cervical necrotizing fasciitis. J R Coll.Surg Edinb. 1997; 42::410413.
    [Google Scholar]
  2. Donald G Gallup, Ramon V Meguiar. Coping with necrotizing fasciitis. Contemporary OB/GY. 2004 Jun; 49::3846.
    [Google Scholar]
  3. Deborah E Setochnik. Soft tissue infections in diabetic patients. InfDis Clin North America. 1995; 9:1:5364.
    [Google Scholar]
  4. Elliott DC, Kufera JA, Myers RAM. Necrotizing soft tissue infections: Risk factors for mortality and strategies for management. Am Surg. 1996; 224::672683.
    [Google Scholar]
  5. Back SA, 0Neill T, Fishbein G, et al., A case of group B streptococcal pyomyositis. Rev InfDis. 1990; 12::784787.
    [Google Scholar]
  6. Singh G, Sinha SK, Adhikary S, et al., Necrotizing infection of soft tissue- a clinical profile. Eur J Surg. 2002; 168::366371.
    [Google Scholar]
  7. Elliott DC, Kufera JA, Myers RAM. Necrotizing soft tissue infections: Risk factors for mortality and strategies for management. Am Surg. 1996; 224::672683.
    [Google Scholar]
  8. Wilkerson R, et al., Necrotizing fasciitis: Case report and review of literature. Clin Orth Rel Res. 1987; 216::187192.
    [Google Scholar]
  9. Patty R, Smith AD:. Gangrene and Fournier's gangrene. Urol Clin North America. 1992; 6::601603.
    [Google Scholar]
  10. Brook F, Frazier EH. Clinical and microbiological features of necrotizing fasciitis. J Clin Microbilo. 1995; 33::2382.
    [Google Scholar]
  11. Sharp CS, Bessman AN, Wagner FW, et al., Microbiology of deep tissue infection in diabetic gangrene. Diabetes Care. 1978; 1::289292.
    [Google Scholar]
  12. Chin-Ho Wong, Lay-Wai Kien-seng , et al., The LRINEC (Laboratory risk indicators for necrotizing fasciitis) score: A tool for distinguishing necrotizing fasciitis from other soft tissue infections. Critic Care Med. 2004; 7::15351541.
    [Google Scholar]
  13. Vincent JL, Moreno R, Takala J. The SOFA (Sequential Organ Failure Assessment) score to describe organ dysfunction /failure. Intensive Care Med. 1999; 22::707710.
    [Google Scholar]
  14. Ronald t Lewis. Necrotizing soft tissue infections. InfDis Clin North America. 1992; 6:3:693700.
    [Google Scholar]
  15. Eke N. Fournier ys gangrene; A review of 1726 cases. Br J Surg. 2000; 87::718728.
    [Google Scholar]
  16. Baskin LS, et al., Necrotizing soft tissue infection of perineum and genitalia. Br J Urol. 1990; 65::524529.
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journals/10.5339/qmj.2009.1.8
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  • Article Type: Research Article
Keyword(s): Diabetes mellitusfootlegnecrotizing fasciitis and Perineum
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