Severe necrotizing soft-tissue infections. Multiple disease entities requiring a common approach.
The spectrum of severe soft-tissue surgical infections extends from synergistic necrotizing soft-tissue infections to histotoxic clostridial infections. These syndromes may demonstrate dramatic destruction of underlying tissue far out of proportion to the external evidence for infection, although a marked systemic response in common. The differential diagnosis hinges on the clinical presentation, the Gram's stain, and operative inspection. More important than the precise label placed on a given case is the early recognition of the urgent surgical nature of the infection. Signs indicating a rapidly spreading soft-tissue infection mandate fluid resuscitation, broad-spectrum antibiotics, and early operative exploration with aggressive debridement. These are highly lethal infections in which timely recognition and effective management may be lifesaving.
D000332:Aerobiosis; D000693:Anaerobiosis; D001424:Bacterial Infections; D003015:Clostridium Infections; D006801:Humans; D009132:Muscles / Q000473:pathology; D009135:Muscular Diseases / Q000209:etiology*; D009336:Necrosis; D013530:Surgical Wound Infection / Q000209:etiology* / Q000601:surgery / Q000628:therapy