6.5. Skin and Soft Tissue Infection - Necrotising Fasciitis Flashcards

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1
Q

Is Necrotising Fasciitis an emergency?

A

Yes, it is one of the infectious disease emergencies

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2
Q

Where can be affected by Necrotising Fasciitis?

A

Any site

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3
Q

What are the predisposing conditions to Necrotising Fasciitis?

A
  1. Diabetes Mellitus
  2. Surgery
  3. Trauma
  4. Peripheral Vascular Disease
  5. Skin Popping
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4
Q

How many types of Necrotising Fasciitis are there?

A

2

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5
Q

What are the types of Necrotising Fasciitis?

A
  1. Type 1 Necrotising Fasciitis
  2. Type 2 Necrotising Fasciitis
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6
Q

What defines Type 1 Necrotising Fasciitis?

A

Mixed Aerobic and Anaerobic infection (Diabetic Foot infection, Fournier’s Gangrene)

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7
Q

What are common organisms in Type 1 Necrotising Fasciitis?

A
  1. Streptococci
  2. Staphylococci
  3. Enterococci
  4. Gram Negative Bacilli
  5. Clostridium
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8
Q

What defines Type 2 Necrotising Fasciitis?

A

It is monomicrobial, normally associated with Streptococcal Pyogenes

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9
Q

What are the Symptoms of Necrotising Fasciitis?

A
  1. Rapid Onset
  2. Sequential development of Erythema, Oedema, and Severe, unremitting pain
  3. Haemorrhagic Bullae, Skin Necrosis and Crepitus may develop
  4. Systematic Features (Fever, Hypotension, Tachycardia, Delirium, Multi-organ failure)
    Note - Anaesthesia at the site of infection is highly suggestive of this disease
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10
Q

What is mandatory in treating Necrotising Fasciitis?

A

Surgical Review
Note - imaging may help but could delay treatment

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11
Q

What antibiotics should be used to treat Necrotising Fasciitis?

A

Broad Spectrum:
1. Flucloxacillin
2. Gentamicin
3. Clindamycin

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12
Q

What is the overall mortality range of Necrotising Fasciitis?

A

17-40%

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