[Differentiated therapy in necrotizing fasciitis of three extremities].
OBJECTIVE
Here we present the clinical symptomatology of and therapy for necrotizing fasciitis.


METHODS
The case of a 35-year-old female patient with sustaining fractures of the 5 (th) and 10 (th) thoracic vertebrae and a pulmonary contusion and without any skin lesions is presented.


RESULTS
Conventional x-rays and computed tomography revealed stable spine fractures not necessitating surgical intervention. Fifteen days after the accident the patient developed septic conditions. An interdisciplinary search (surgical, neurological, urological, internal medicine) for the septic focus first remained negative. After demarcation of necrotic skin areas at the upper left arm, bilateral necrotizing fasciitis was diagnosed at both thighs and at the lower left leg, necessitating continuous optimisation of the therapeutic strategy.


CONCLUSIONS
Local aggressive surgical therapy in combination with systemic antibiotic administration is the therapy of choice in treatment of the necrotizing fasciitis. It should be performed according to the principle "life before limb". In the presented case the patient recovered and good functional results could be achieved.
Siekmann
H
H
Universitätsklinikum Leipzig, Abteilung für Unfall-, Wiederherstellungs- und Plastische Chirurgie. Holger.Siekmann@medizin.uni-leipzig.de
Marquass
B
B
Glasmacher
S
S
Tiemann
A
A
Josten
C
C
D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D005121:Extremities / Q000473:pathology* / Q000601:surgery*; D019115:Fasciitis, Necrotizing / Q000175:diagnosis* / Q000628:therapy*; D005260:Female; D006801:Humans; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents