Necrotizing fasciitis of the vulva.
OBJECTIVE
We attempted to characterize the natural history of necrotizing fasciitis of the vulva.


METHODS
The records of 29 nonpregnant women with necrotizing fasciitis of the vulva were evaluated.


RESULTS
These women experienced a rapidly progressing polymicrobial infection. Initially, the infections in many women were thought to be labial cellulitis, appearing mild and innocuous. Delays in recognition and aggressive surgical management were associated with increased morbidity and mortality. Of 15 women with a delay greater than 48 hours between presentation and treatment, 11 died. Twenty of 29 (69%) were diabetic, accounting for 11 of the 14 deaths.


CONCLUSIONS
Early diagnosis and aggressive surgical debridement in spite of mild symptoms will improve outcome in this serious disease process.
Stephenson
H
H
Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina, Chapel Hill 27599.
Dotters
D J
DJ
Katz
V
V
Droegemueller
W
W
D000328:Adult; D000368:Aged; D001424:Bacterial Infections / Q000382:microbiology / Q000601:surgery; D001441:Bacteroides fragilis / Q000302:isolation & purification; D003016:Clostridium perfringens / Q000302:isolation & purification; D003017:Clostridium tetani / Q000302:isolation & purification; D004926:Escherichia coli / Q000302:isolation & purification; D005208:Fasciitis / Q000382:microbiology / Q000401:mortality / Q000601:surgery*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009336:Necrosis; D010462:Peptostreptococcus / Q000302:isolation & purification; D013997:Time Factors; D014847:Vulvitis / Q000382:microbiology / Q000401:mortality / Q000601:surgery*