Chapter 26: Surgical Infections- Necrotizing Fasciitis Flashcards
1
Q
What is it?
A
Bacterial infection of underlying fascia (spreads rapidly along fascial planes)
2
Q
What are the causative agents?
A
- Classically, group A Streptococcus pyogenes,
- but most often polymicrobial with anaerobes/gram-negative organisms
3
Q
What are the signs/symptoms?
A
- Fever
- pain
- crepitus
- cellulitis
- skin discoloration,
- blood blisters (hemorrhagic bullae)
- weeping skin
- increased WBCs
- subcutaneous air on x-ray
- septic shock
4
Q
What is the LRINEC score for necrotizing fasciitis?
A
Laboratory Risk Indicator for NECrotizing fasciitis
5
Q
What are the values for the LRINEC associated with necrotizing fasciitis?
A
- C-reactive protein >150
- WBC >15
- HGB <13.5
- sodium <135
- creatinine >1.6
- glucose >180
6
Q
What is the treatment?
A
- IVF,
- IV antibiotics
- aggressive early extensive surgical débridement
- cultures
- tetanus prophylaxis
7
Q
What antibiotics?
A
Triple therapy: for example,
- Zosyn®
- vancomycin
- clindamycin
8
Q
Why clindamycin?
A
Binds STAPH/STREP exotoxin
9
Q
Is necrotizing fasciitis an emergency?
A
YES, patients must be taken to the O.R. immediately!
