6.5. Skin and Soft Tissue Infection - Necrotising Fasciitis Flashcards
Is Necrotising Fasciitis an emergency?
Yes, it is one of the infectious disease emergencies
Where can be affected by Necrotising Fasciitis?
Any site
What are the predisposing conditions to Necrotising Fasciitis?
- Diabetes Mellitus
- Surgery
- Trauma
- Peripheral Vascular Disease
- Skin Popping
How many types of Necrotising Fasciitis are there?
2
What are the types of Necrotising Fasciitis?
- Type 1 Necrotising Fasciitis
- Type 2 Necrotising Fasciitis
What defines Type 1 Necrotising Fasciitis?
Mixed Aerobic and Anaerobic infection (Diabetic Foot infection, Fournier’s Gangrene)
What are common organisms in Type 1 Necrotising Fasciitis?
- Streptococci
- Staphylococci
- Enterococci
- Gram Negative Bacilli
- Clostridium
What defines Type 2 Necrotising Fasciitis?
It is monomicrobial, normally associated with Streptococcal Pyogenes
What are the Symptoms of Necrotising Fasciitis?
- Rapid Onset
- Sequential development of Erythema, Oedema, and Severe, unremitting pain
- Haemorrhagic Bullae, Skin Necrosis and Crepitus may develop
- Systematic Features (Fever, Hypotension, Tachycardia, Delirium, Multi-organ failure)
Note - Anaesthesia at the site of infection is highly suggestive of this disease
What is mandatory in treating Necrotising Fasciitis?
Surgical Review
Note - imaging may help but could delay treatment
What antibiotics should be used to treat Necrotising Fasciitis?
Broad Spectrum:
1. Flucloxacillin
2. Gentamicin
3. Clindamycin
What is the overall mortality range of Necrotising Fasciitis?
17-40%