title: Necrotizing fasciitis: eight-year experience and literature review.
abstract: OBJECTIVE
  To describe clinical, laboratory, microbiological features, and outcomes of necrotizing fasciitis.
  
  
  METHODS
  From January 1, 2004 to December 31, 2011, 115 patients (79 males, 36 females) diagnosed with necrotizing fasciitis were admitted to Mackay Memorial Hospital in Taitung. Demographic data, clinical features, location of infection, type of comorbidities, microbiology and laboratory results, and outcomes of patients were retrospectively analyzed.
  
  
  RESULTS
  Among 115 cases, 91 survived (79.1%) and 24 died (20.9%). There were 67 males (73.6%) and 24 females (26.4%) with a median age of 54 years (inter-quartile ranges, 44.0-68.0 years) in the survival group; and 12 males (50%) and 12 females (50%) with a median age of 61 years (inter-quartile ranges, 55.5-71.5 years) in the non-surviving group. The most common symptoms were local swelling/erythema, fever, pain/tenderness in 92 (80%), 87 (76%) and 84 (73%) patients, respectively. The most common comorbidies were liver cirrhosis in 54 patients (47%) and diabetes mellitus in 45 patients (39%). A single organism was identified in 70 patients (61%), multiple pathogens were isolated in 20 patients (17%), and no microorganism was identified in 30 patients (26%). The significant risk factors were gender, hospital length of stay, and albumin level.
  
  
  CONCLUSIONS
  Necrotizing fasciitis, although not common, can cause notable rates of morbidity and mortality. It is important to have a high index of suspicion and increase awareness in view of the paucity of specific cutaneous findings early in the course of the disease. Prompt diagnosis and early operative debridement with adequate antibiotics are vital.
authors.affiliation: Division of Urology, Department of Surgery, Mackay Memorial Hospital, Taitung, Taiwan, ROC. Electronic address: linmyintaye@gmail.com.
authors.forename: Jinn-Ming
authors.initials: JM
authors.lastname: Wang
authors.affiliation: Division of Infectious Diseases, Department of Medicine, Mackay Memorial Hospital, Taitung, Taiwan, ROC.
authors.forename: Hwee-Kheng
authors.initials: HK
authors.lastname: Lim
mesh_terms: D000328:Adult; D000368:Aged; D000671:Amputation, Surgical; D003646:Debridement; D019115:Fasciitis, Necrotizing / Q000175:diagnosis / Q000382:microbiology / Q000401:mortality* / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology
keywords: Antibiotics; Comorbidity; Debridement; Necrotizing fasciitis