Continuous renal replacement therapy as a supportive treatment for acute pediatric necrotizing fasciitis.
Acute necrotizing fasciitis (NF) in children is a dangerous illness characterized by progressive necrosis of the skin and subcutaneous tissue. The present study summarizes our recent experience with the treatment of pediatric patients with severe NF. Between 2000 and 2009, eight children suffering from NF were admitted to our department. Four of the children received an active treatment strategy including continuous renal replacement therapy (CRRT), radical debridement, and broad-spectrum antibiotics. Another four children presented at a late stage of illness, and did not complete treatment. Clinical data for these two patient groups were retrospectively analyzed. The four patients that completed CRRT, radical debridement, and a course of broad-spectrum antibiotics were cured without any significant residual morbidity. The other four infants died shortly after admission. Early diagnosis, timely debridement, and aggressive use of broad-spectrum antibiotics are key factors for achieving a satisfactory outcome for cases of acute NF. Early intervention with CRRT to prevent septic shock may also improve patient outcome.
The Burns Department, Zhujing Hospital, Southern Medical University, Guangzhou, 510280, China, shengjunshi@yahoo.com.
Shengjun
S
Shi
Siyuan
S
Jia
Jingwen
J
Liu
Guangping
G
Chen
Sijie
S
He
D000208:Acute Disease; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002675:Child, Preschool; D019115:Fasciitis, Necrotizing / Q000188:drug therapy* / Q000382:microbiology; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification; D009336:Necrosis; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification; D017582:Renal Replacement Therapy; D012189:Retrospective Studies; D013211:Staphylococcus aureus / Q000302:isolation & purification; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents