Necrotizing fasciitis: a challenging diagnosis.
The objective of the study was to evaluate our recent experience in diagnosis and management of necrotizing fasciitis. Records of patients who were diagnosed as having necrotizing fasciitis at Al-Ain Hospital in the period between March 2003 and August 2005 were studied retrospectively with regard to clinical features, risk factors, diagnosis, causative organisms, treatment, and outcome. Eleven patients, eight of whom were men of low socio-economic status, were studied. The median age (range) was 46 (8-65) years. The main risk factor was diabetes mellitus in seven patients (64%). The provisional clinical diagnosis was incorrect in seven patients (64%). Pure beta-hemolytic streptococcus group A or B was the causative organism in five patients (46%). Most of our patients underwent multiple surgical debridements with a median range of two (1-11) operations. Two patients died (overall mortality rate 18%). High clinical suspicion is essential for the diagnosis of necrotizing fasciitis. Accurate early diagnosis, aggressive resuscitation, using proper antibiotics, and extensive surgical debridement are essential for a favorable outcome.
Hefny
Ashraf F
AF
Department of Surgery, Al-Ain Hospital, UAE University, Al-Ain, United Arab Emirates.
Eid
Hani O
HO
Al-Hussona
Mudher
M
Idris
Kamal M
KM
Abu-Zidan
Fikri M
FM
D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D003646:Debridement; D048909:Diabetes Complications / Q000175:diagnosis / Q000628:therapy; D003951:Diagnostic Errors; D019115:Fasciitis, Necrotizing / Q000175:diagnosis* / Q000209:etiology / Q000401:mortality / Q000628:therapy; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D012923:Social Class; D013290:Streptococcal Infections / Q000150:complications*; D013291:Streptococcus / Q000302:isolation & purification
D000900:Anti-Bacterial Agents