[Necrotizing fasciitis. A diagnostic and therapeutic challenge].
A case of necrotizing fasciitis of the upper limb caused by group A streptococcal infection and a case with an abscess of the hand caused by staphylococcus aureus, are presented. The anatomo-pathological and clinical differences between the two different types of infection are underlined and stress is laid on the excruciating pain, the high temperature and the rapidly spreading inflammatory-necrotizing evolution of the first case. More than the anatomo-pathological findings of a necrotic area the authors consider more important, the rapidity and the severity of the infection, that can evolve into a toxic shock-like syndrome, and the microbiological isolation of the streptococcus type A. On the basis of personal experience and of an accurate review of the literature, a therapeutical protocol is proposed based on an aggressive surgical approach, prompt specific antibiotic treatment and daily control of the lesions.
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Servizio di Pronto Soccorso e Accettazione, ASL 25, Ospedale Maggiore, Lodi.
Bonvicini
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Zanola
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Ceraminiello
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D000328:Adult; D019115:Fasciitis, Necrotizing / Q000175:diagnosis* / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male