title: [Necrotizing fasciitis: a medical and surgical emergency. Apropos of a case].
abstract: We report about a 66-years-old obese and diabetic female patient, treated with anti-inflammatories for osteoarthritis of the hip and operated for varices of the lower limbs by a bilateral stripping of the internal saphenous veins, who presented with a mortal necrotizing fasciitis during the postoperative period. Necrotizing fasciitis is a severe, infrequent disease jeopardizing the vital prognosis, in which an appropriate and early treatment (medical, using antibiotics, and surgical by extensive debridement) can prevent a fatal outcome. The most often involved germs are streptococci (45%). The association of anaerobic and aerobic germs sometimes causes mixed cellulitis. The vital prognosis is always threatened by postoperative fasciitis. The mortality rate ranges from 50 to 75%, the main causes of death being a septic shock or pulmonary embolism. The functional prognosis of the surviving patients depends on the extent and quality of surgery.
authors.affiliation: Service de Chirurgie Thoracique et Cardio-Vasculaire, CHU Dupuytren, Limoges.
authors.forename: E
authors.initials: E
authors.lastname: Cornu
authors.forename: C
authors.initials: C
authors.lastname: Christides
authors.forename: P
authors.initials: P
authors.lastname: Lacroix
authors.forename: P
authors.initials: P
authors.lastname: Virot
authors.forename: S
authors.initials: S
authors.lastname: Sekkal
authors.forename: C
authors.initials: C
authors.lastname: Serhal
authors.forename: F
authors.initials: F
authors.lastname: Bertin
authors.forename: M
authors.initials: M
authors.lastname: Laskar
mesh_terms: D000368:Aged; D000658:Amoxicillin / Q000627:therapeutic use; D019818:Clavulanic Acid; D002969:Clavulanic Acids / Q000627:therapeutic use; D003131:Combined Modality Therapy; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D004635:Emergency Medicine; D005208:Fasciitis / Q000188:drug therapy / Q000209:etiology / Q000382:microbiology / Q000601:surgery*; D005260:Female; D006801:Humans; D009336:Necrosis; D011183:Postoperative Complications; D011379:Prognosis; D013290:Streptococcal Infections / Q000150:complications; D014648:Varicose Veins / Q000150:complications / Q000601:surgery*
chemical_list: D002969:Clavulanic Acids; D019818:Clavulanic Acid; D000658:Amoxicillin
vernacular_title: Fasciite nécrosante: une urgence médicale et chirurgicale. A propos d'un cas.