title: [Necrotizing infections of the soft tissues. Apropos of 40 cases].
abstract: The diagnosis of necrotizing soft tissue infection (NSTI) is based on a high suspicion index and/or clinical experience. Mortality is associated with delayed diagnosis and use of early surgical treatment, and also with the underlying disease and the patient's age. Usually they are mixed infections; therefore, in addition to surgical therapy an adequate antibiotic coverage is required. The latter, in cases of severe renal failure, might consist in monotherapy. All these guidelines can be modified on the basis of bacteriological findings. The Gram stain of a surgical sample can be very useful to select an appropriate empirical therapy. From a clinical point of view, we suggest to pay extreme attention to the findings consistent with NSTI: tenderness and/or crackling of soft tissue, rapid expansion through natural planes, or visualization of gas in the x-ray film of the involved zone, particularly if associated with a rapid deterioration of the general condition of the patient.
authors.affiliation: Servicio de Microbiología Clínica, Hospital Universitario de Valme, Sevilla.
authors.forename: A
authors.initials: A
authors.lastname: Sánchez Porto
authors.forename: M
authors.initials: M
authors.lastname: Martín Gómez
authors.forename: C
authors.initials: C
authors.lastname: León Gil
authors.forename: E
authors.initials: E
authors.lastname: Martín Mazuelos
authors.forename: J
authors.initials: J
authors.lastname: Marín Morales
authors.forename: A
authors.initials: A
authors.lastname: Royo Balbontín
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001424:Bacterial Infections / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology* / Q000628:therapy; D002648:Child; D003646:Debridement; D004322:Drainage; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D012189:Retrospective Studies; D013030:Spain / Q000453:epidemiology
chemical_list: D000900:Anti-Bacterial Agents