Necrotising fasciitis Flashcards
Types
Type 1: caused by mixed anaerobes and aerobes (post-surgery in diabetics) and is the most common type
Type 2: cause by strep pyogenes
Risk factors
Skin factors: recent trauma, burns or soft tissue infections
DM: most common preexisting medical condition, particularly if treated with SGLT2 inhibitors
IVDU
Immunosuppression
Most commonly affected site
Perinium (Fournier’s gangrene)
Features
Acute onset
Pain, swelling, erythema at the affected site
Often presents as rapidly worsening cellulitis with pain out of keeping with physical features
Extremely tender over infected area with hypoaesthesia to light touch
SKin necrosis and crepitus/gas are late signs
Fever and tachycardia may be absent or occur late in presentation
Management
Urent surgical referral debridement
IV antibitoics
Prognosis
Average mortality of 20%