Necrotizing Fascitis

Question 1

Most common organisms in necrotizing fasciitis

Answer 1

Group A strep and mixed anaerobic flora

Question 2

Risk factors for necrotizing fasciitis

Answer 2

Diabetes, IVDA, trauma surgery, Chronic liver and renal disease, malignancy

Question 3

S/S of Necrotizing Fasciitis

Answer 3

Toxic appearing, bullae, skin necrosis, rhabdo, DIC
Soft tissue edema and erythema
Red hot shiny swollen and tender

Question 4

S/S of untreated necrotizing fasciitis

Answer 4

Blue grey patches develop after 36 hours
Cutaneous bullae and necrosis after 3-5 days
Decreased pain

Question 5

S/s of necrotizing fasciitis d/t clostridium perfringens

Answer 5

Extremely toxic
High mortality rate
48 hours rapid tissue invasion and systemic toxicity and death

Question 6

Necrotizing fasciitis tx plan (labs, ABX, supportive care, procedures)

Answer 6

Labs: sepsis workup
ABX: Vanco plus clindamycin plus gentamycin
IVF
Urgent surgical debridement