Necrotizing Fasciitis: Causes, Risk factors, Symptoms and Treatment.

Necrotizing fasciitis is known as flesh-eating disease. It is a rapid. destructive. invasive. infective condition of the skin. subcutaneous tissue. . deep fascia of the body. Necrotizing fasciitis is a medical emergency. Necrotizing Fasciitis mainly affects the following areas of the body 1. Groin 2. Anterior abdominal wall 3. Lower extremities 4. Genitals INCIDENCE IN THE WORLD Necrotizing Fasciitis affects about 0.4 in every 100.000 people per year in the United States. About 1.000 cases of necrotizing fasciitis occur per year in the United States. . the rates have been increasing day by day because of the low immune response of the body. HISTORICAL BACKGROUND It was first described by the Army surgeon Joseph Jones during the civil war. TYPES OF NECROTIZING FASCIITIS 1. Type 1/ Polymicrobial Infection It is the most common type of infection. Mainly bacterias are addressing into this category such as- This type of infection is usually caused by various species of Gram-positive cocci. ( Staphylococcus aureus . Streptococcus pyogenes . . enterococci). Gram-negative rods. ( Escherichia coli . Pseudomonas aeruginosa ). . anaerobes. ( Bacteroides . Clostridium species.) 2. Type 2/ Streptococcus Infections About 30% cases of necrotizing fasciitis are associated with Group A Streptococcus pyogenes bacteria. These streptococcus manifest as toxic shock syndrome. 3. Type 3 / Vibrio Vulnificus These type of infections happens because of break down of skin through saltwater. Vibrio Vulnificus found in saltwater mainly. 4. Type 4 / Fungal Infections Mucoraceous fungi lead to this type of infection. ETIOLOGY 1. Low socio-economic people mainly affected by necrotizing fasciitis because of there unawareness or careless attitude. 2. Immunosuppressant patients who suffer from chronic diabetic conditions or AIDS-like diseases. 3. Insect bite injuries 4. Cuts . burns. 5. NSAIDs uses in the varicella-zoster like infections. 6. Smoking. 7. Tobacco chewing 8. Alcoholism also increases the risk of necrotizing fasciitis. All these above factors are quietly associated with the bacterial invasion . infection in the body. SYMPTOMS 1.Gross swelling of the affected area. 2. Pain 3. A necrotic patch of the skin 4. Subcutaneous induration 5. Bullae 6. Erythema 7. Surgical emphysema 8. The profuse . foul smell of the discharge 9. Irregular edge ulcers DIAGNOSIS The gold standard for diagnosis is a surgical exploration in a setting of high suspicion. When in doubt. a small incision can be made into the affected tissue. . if a finger easily separates the tissue along the fascial plane. the diagnosis is confirmed . an extensive debridement should be performed. INVESTIGATION Investigation for necrotizing fasciitis is important for proper diagnosis of the disease. Computer tomography Magnetic resonance imagining (LRINEC) Score- It is a scoring factor of 6 indicators of the infection. It is may disrupt the true image of the disease because if other infections are present in the body. If LRINEC score ≥ 6 have a higher rate of both death . amputation. This LRINEC scoring system was introduced by Wong . colleagues in 2004. It uses six laboratory values: C-reactive protein. total white blood cell count. haemoglobin. sodium. creatinine. . blood glucose. A score of 6 or more indicates that necrotizing fasciitis should be seriously considered. The scoring criteria are: C RP (mg/L) ≥150: 4 points W BC count (×10 3 /mm 3 ) <15: 0 points 15–25: 1 point >25: 2 points H emoglobin (g/dl) >13.5: 0 points 11–13.5: 1 point <11: 2 points S odium (mmol/l) <135: 2 points C reatinine (umol/l) >141: 2 points G lucose (mmol/l) >10: 1 point [15][16] However. the scoring system has not been validated. The values would be falsely positive if any other inflammatory conditions are present. Prevention Proper cleaning . management of the injuries. TREATMENT 1. Surgical Debridement or Amputation of the affected part. 2.Broad-spectrum antibiotics Such as Moxifloxacin (a fluoroquinolone) . amoxicillin-clavulanate (penicillin) . evaluated the appropriate duration of treatment (varying from 7 to 21 days). 3. Antifungal medications 4. Hyperbaric oxygen therapy. COMPLICATIONS 1. Streptococcal toxic shock syndrome 2. Compartment syndrome 3. Myositis 4. Muscle necrosis. Read more health-related articles to stay healthy . fit. health fitness nutrition wellness mental health diet yoga exercise weight loss home remedies natural curehealth fitness nutrition wellness mental health diet yoga exercise weight loss home remedies natural curehealth fitness nutrition wellness mental health diet yoga exercise weight loss home remedies natural cure