Author: Peter Bakes, MD

Educational Pearls:

• Necrotizing fasciitis is an infection of the deep soft tissues with destruction of the muscle fascia and overlying fat
• Think of it if pain is out of proportion to your exam
• Polymicrobial and Clostridium species typically cause condition in susceptible individuals (immunocompromised, diabetics, obese, penetrating injury)
• Group A strep typically is less specific and can cause necrotizing infections in otherwise healthy individuals
• Treatment is typically rapid surgical debridement in addition to broad spectrum antibiotics in addition to clindamycin

References:

Breyre A, Frazee BW. Skin and Soft Tissue Infections in the Emergency Department. Emerg Med Clin North Am. 2018 Nov;36(4):723-750. doi: 10.1016/j.emc.2018.06.005. Review. PubMed PMID: 30297001.

Stevens DL, Bryant AE. Necrotizing Soft-Tissue Infections. N Engl J Med. 2017 Dec 7;377(23):2253-2265. doi: 10.1056/NEJMra1600673. Review. PubMed PMID: 29211672.

Summary by Travis Barlock, MS4 | Edited by Erik Verzemnieks, MD