title: Hepatitis C viral infection as an associated risk factor for necrotizing fasciitis.
abstract: Necrotizing fasciitis is a rare soft tissue infection associated with a high mortality rate. Several risk factors for the development of necrotizing fasciitis have been studied, which has given surgeons insight into the types of patients who are more likely to present with this rapidly progressive infection. The concomitant diagnosis of hepatitis C viral infection has not been reported in the literature previously. In this retrospective study covering a 12-year period in 1 Level I trauma center, 10 (34%) of 29 patients presenting with necrotizing fasciitis had an underlying diagnosis of hepatitis C viral infection. The mortality rate in patients with hepatitis C viral infection was 30% compared with 21% for those without hepatitis C viral infection (P=.59). The proportion of patients presenting with the concomitant diagnosis of hepatitis C viral infection and necrotizing fasciitis was statistically greater than that expected from the prevalence of hepatitis C viral infection in the general population (1.8%; P<.001).Our study showed that hepatitis C viral infection is a risk factor for developing necrotizing fasciitis. Although our sample size was too small to show a statistical significance, we believe that a clinically significant increase in mortality of necrotizing fasciitis occurred in patients with concomitant hepatitis C viral infection. Therefore, the presence of hepatitis C viral infection in patients presenting with symptoms of necrotizing fasciitis should raise the clinical suspicion for this diagnosis, with the potential for a worse prognosis.
authors.affiliation: Department of Orthopaedic Surgery and Rehabilitation, William Beaumont Army Medical Center, El Paso, Texas, USA.
authors.forename: Danielle
authors.initials: D
authors.lastname: Scher
authors.forename: Enes
authors.initials: E
authors.lastname: Kanlic
authors.forename: Julia
authors.initials: J
authors.lastname: Bader
authors.forename: Melchor
authors.initials: M
authors.lastname: Ortiz
authors.forename: Amr
authors.initials: A
authors.lastname: Abdelgawad
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015897:Comorbidity; D019115:Fasciitis, Necrotizing / Q000175:diagnosis* / Q000401:mortality*; D005260:Female; D006526:Hepatitis C / Q000175:diagnosis* / Q000401:mortality*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D016019:Survival Analysis; D015996:Survival Rate; D013781:Texas / Q000453:epidemiology; D055815:Young Adult