title: Necrotizing fasciitis of the upper extremity.
abstract: Twelve cases of necrotizing fasciitis were identified retrospectively over a 5-year period. All were associated with a history of substance abuse by injection or with diabetes. Eleven of the 12 infections were associated with beta-hemolytic Streptococcus, a mixed anaerobic aerobic infection, or both. Three of five patients tested for human immunodeficiency virus had positive test results. A wide extensile approach was used to debride necrotic fascia. An average of 3 debridements were necessary, with a range of 1-6 debridements. Two patients under-went shoulder disarticulation because of uncontrollable infection. The rapid and destructive nature of this disease makes early recognition, aggressive debridement, and antibiotic therapy necessary to minimize morbidity.
authors.affiliation: Department of Orthopaedics, University of Illinois at Chicago 60612-7342, USA.
authors.forename: M H
authors.initials: MH
authors.lastname: Gonzalez
authors.forename: T
authors.initials: T
authors.lastname: Kay
authors.forename: N
authors.initials: N
authors.lastname: Weinzweig
authors.forename: A
authors.initials: A
authors.lastname: Brown
authors.forename: J
authors.initials: J
authors.lastname: Pulvirenti
mesh_terms: D000328:Adult; D001132:Arm; D003646:Debridement; D048909:Diabetes Complications; D019115:Fasciitis, Necrotizing / Q000150:complications / Q000382:microbiology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D019966:Substance-Related Disorders / Q000150:complications