title: [Necrotizing fasciitis. A diagnostic and therapeutic challenge].
abstract: 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.
authors.affiliation: Servizio di Pronto Soccorso e Accettazione, ASL 25, Ospedale Maggiore, Lodi.
authors.forename: G
authors.initials: G
authors.lastname: Ciccone
authors.forename: R
authors.initials: R
authors.lastname: Bonvicini
authors.forename: S
authors.initials: S
authors.lastname: Zanola
authors.forename: M
authors.initials: M
authors.lastname: Bombonato
authors.forename: A
authors.initials: A
authors.lastname: Ceraminiello
mesh_terms: D000328:Adult; D019115:Fasciitis, Necrotizing / Q000175:diagnosis* / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male