Post by Master Kim on Jan 24, 2015 15:17:10 GMT -5
Necrotizing fasciitis - en.wikipedia.org/wiki/Necrotizing_fasciitis
Necrotizing fasciitis (/ˈnɛkrəˌtaɪzɪŋ ˌfæʃiˈaɪtɪs/ or /ˌfæs-/) or NF, commonly known as flesh-eating disease, flesh-eating bacteria or flesh-eating bacteria syndrome, is a rare infection of the deeper layers of skin and subcutaneous tissues, easily spreading across the fascial plane within the subcutaneous tissue. The most consistent feature of necrotizing fasciitis was first described in 1952 as necrosis of the subcutaneous tissue and fascia with relative sparing of the underlying muscle.
Necrotizing fasciitis progresses rapidly, having greater risk of developing in the immunocompromised due to conditions such as diabetes or cancer. It is a severe disease of sudden onset and is usually treated immediately with surgical debridement and large doses of intravenous antibiotics, with delay in surgical treatment being associated with higher mortality.
Many types of bacteria can cause necrotizing fasciitis (e.g., Group A streptococcus (Streptococcus pyogenes), Staphylococcus aureus, Clostridium perfringens, Bacteroides fragilis, Vibrio vulnificus, Aeromonas hydrophila). The disease is classified as Type I (polymicrobial, due to a number of different organisms) or Type II (monomicrobial, due to a single infecting organism). The majority of cases of necrotizing fasciitis are polymicrobial, with 25–45% of cases being Type II. Such infections are more likely to occur in people with compromised immune systems secondary to chronic disease.
Historically, most cases of Type II infections have been due to group A streptococcus and staphylococcal species. Since as early as 2001, a form of monomicrobial necrotizing fasciitis which is particularly difficult to treat has been observed with increasing frequency caused by methicillin-resistant Staphylococcus aureus (MRSA).
43-year-old Caucasian male with necrotizing fasciitis. Preoperative photograph on the day of admission. Extensive erythema and necrosis of the left leg.
Signs and symptoms
Over 70% of cases are recorded in people with at least one of the following clinical situations: immunosuppression, diabetes, alcoholism/drug abuse/smoking, malignancies, and chronic systemic diseases. For reasons that are unclear, it occasionally occurs in people with an apparently normal general condition.
The infection begins locally at a site of trauma, which may be severe (such as the result of surgery), minor, or even non-apparent. People usually complain of intense pain that may seem excessive given the external appearance of the skin. People initially have signs of inflammation, fever and tachycardia. With progression of the disease, often within hours, tissue becomes progressively swollen, the skin becomes discolored and develops blisters. Crepitus may be present and there may be discharge of fluid, said to resemble "dish-water". Diarrhea and vomiting are also common symptoms.
In the early stages, signs of inflammation may not be apparent if the bacteria are deep within the tissue. If they are not deep, signs of inflammation, such as redness and swollen or hot skin, develop very quickly. Skin color may progress to violet, and blisters may form, with subsequent necrosis (death) of the subcutaneous tissues.
Furthermore, people with necrotizing fasciitis typically have a fever and appear very ill. Mortality rates have been noted as high as 73 percent if left untreated. Without surgery and medical assistance, such as antibiotics, the infection will rapidly progress and will eventually lead to death.
Necrotizing fasciitis (/ˈnɛkrəˌtaɪzɪŋ ˌfæʃiˈaɪtɪs/ or /ˌfæs-/) or NF, commonly known as flesh-eating disease, flesh-eating bacteria or flesh-eating bacteria syndrome, is a rare infection of the deeper layers of skin and subcutaneous tissues, easily spreading across the fascial plane within the subcutaneous tissue. The most consistent feature of necrotizing fasciitis was first described in 1952 as necrosis of the subcutaneous tissue and fascia with relative sparing of the underlying muscle.
Necrotizing fasciitis progresses rapidly, having greater risk of developing in the immunocompromised due to conditions such as diabetes or cancer. It is a severe disease of sudden onset and is usually treated immediately with surgical debridement and large doses of intravenous antibiotics, with delay in surgical treatment being associated with higher mortality.
Many types of bacteria can cause necrotizing fasciitis (e.g., Group A streptococcus (Streptococcus pyogenes), Staphylococcus aureus, Clostridium perfringens, Bacteroides fragilis, Vibrio vulnificus, Aeromonas hydrophila). The disease is classified as Type I (polymicrobial, due to a number of different organisms) or Type II (monomicrobial, due to a single infecting organism). The majority of cases of necrotizing fasciitis are polymicrobial, with 25–45% of cases being Type II. Such infections are more likely to occur in people with compromised immune systems secondary to chronic disease.
Historically, most cases of Type II infections have been due to group A streptococcus and staphylococcal species. Since as early as 2001, a form of monomicrobial necrotizing fasciitis which is particularly difficult to treat has been observed with increasing frequency caused by methicillin-resistant Staphylococcus aureus (MRSA).
43-year-old Caucasian male with necrotizing fasciitis. Preoperative photograph on the day of admission. Extensive erythema and necrosis of the left leg.
Signs and symptoms
Over 70% of cases are recorded in people with at least one of the following clinical situations: immunosuppression, diabetes, alcoholism/drug abuse/smoking, malignancies, and chronic systemic diseases. For reasons that are unclear, it occasionally occurs in people with an apparently normal general condition.
The infection begins locally at a site of trauma, which may be severe (such as the result of surgery), minor, or even non-apparent. People usually complain of intense pain that may seem excessive given the external appearance of the skin. People initially have signs of inflammation, fever and tachycardia. With progression of the disease, often within hours, tissue becomes progressively swollen, the skin becomes discolored and develops blisters. Crepitus may be present and there may be discharge of fluid, said to resemble "dish-water". Diarrhea and vomiting are also common symptoms.
In the early stages, signs of inflammation may not be apparent if the bacteria are deep within the tissue. If they are not deep, signs of inflammation, such as redness and swollen or hot skin, develop very quickly. Skin color may progress to violet, and blisters may form, with subsequent necrosis (death) of the subcutaneous tissues.
Furthermore, people with necrotizing fasciitis typically have a fever and appear very ill. Mortality rates have been noted as high as 73 percent if left untreated. Without surgery and medical assistance, such as antibiotics, the infection will rapidly progress and will eventually lead to death.
subdue LU10, ST41, SP2, HT8, BL60, KI2 and LR2.