scholarly journals Necrotizing soft tissue infection at an uncommon site following tooth extraction

2019 ◽  
Vol 6 (12) ◽  
pp. 4557
Author(s):  
Raksha R. ◽  
Varsha S. ◽  
S. Rajagopalan
Keyword(s):  
Soft Tissue ◽  
Necrotizing Fasciitis ◽  
Soft Tissue Infection ◽  
Rare Case ◽  
Tooth Extraction ◽  
Subcutaneous Tissue ◽  
Tissue Infection ◽  
Lower Abdomen ◽  
Necrotizing Soft Tissue Infection ◽  
Progressive Necrosis

Necrotizing soft tissue infection (NSTI) is a disease characterized by rapidly progressive necrosis involving skin, subcutaneous tissue, fascia or muscle. It is commonly seen in extremities, perineum and lower abdomen. It is extremely uncommon for necrotizing fasciitis to occur along the chest wall, with only a few such cases being reported. We report one such rare case of NSTI in a 75 year old male who underwent left molar tooth extraction developed Ludwig’s angina which progressed to present as a painful swelling over the left side of the neck and chest with a necrotic patch of skin over manubrium sternum managed successfully.

Soft Tissue Infection

2019 ◽  
Author(s):  
Mark A. Malangoni ◽  
Christopher R McHenry
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Infection ◽  
Toxic Shock Syndrome ◽  
Bacterial Infections ◽  
Subcutaneous Tissue ◽  
Tissue Infection ◽  
Soft Tissue Infections ◽  
Toxic Shock ◽  
Necrotizing Soft Tissue Infection ◽  
Human Bites

Soft tissue infections are a diverse group of diseases that involve the skin and underlying subcutaneous tissue, fascia, or muscle. The authors review the diagnosis and management of the main soft tissue infections seen by surgeons, including both superficial infections and necrotizing infections. When the characteristic clinical features of necrotizing soft tissue infection are absent, diagnosis may be difficult. In this setting, laboratory and imaging studies become important. Studies emphasizes that computed tomography should continue to be used judiciously as an adjunct to clinical judgment. The delay between hospital admission and initial débridement is the most critical factor influencing morbidity and mortality. Once the diagnosis of necrotizing soft tissue infection is established, patient survival and soft tissue preservation are best achieved by means of prompt operation. Bacterial infections of the dermis and epidermis are covered in depth, along with animal and human bites. Methicillin-resistant Staphylococcus aureus (MRSA) accounts for up to 70% of all S. aureus infections acquired in the community and is the most common organism identified in patients presenting to the emergency department with a skin or soft tissue infection. The more classic findings associated with deep necrotizing infections—skin discoloration, the formation of bullae, and intense erythema—occur much later in the process. It is important to understand this point so that an early diagnosis can be made and appropriate treatment promptly instituted. The review’s discussion covers in depth the etiology and classification of soft tissue infection, pathogenesis of soft tissue infections, toxic shock syndrome, and reports on mortality from necrotizing soft tissue infection. This review 8 figures, 22 tables, and 58 references. Keywords: Erysipelas, cellulitis, soft tissue infection, necrotizing fasciitis, myonecrosis, toxic shock syndrome

scholarly journals Necrotizing Fasciitis of The Abdominal Wall Following Colonoscopy with Fatal Outcome - A Case Report

2019 ◽  
pp. 1-3
Author(s):  
Daniel Matz ◽  
Oleg Heizmann
Keyword(s):  
Soft Tissue ◽  
Necrotizing Fasciitis ◽  
Soft Tissue Infection ◽  
Group A Streptococcus ◽  
Subcutaneous Tissue ◽  
Fatal Outcome ◽  
Anaerobic Bacteria ◽  
Tissue Infection ◽  
Life Threatening ◽  
Staphylococcus Spp

Necrotizing fasciitis (NF) is a serious and potentially life threatening soft tissue infection, usually caused by different types of bacteria such as group A streptococcus, staphylococcus spp. (type 1 infection) or mixed infection by aerobic and anaerobic bacteria (type 2 infection). Usually, the infection arises from skin injury, in injections or surgical procedures and effects the fascia as well as the subcutaneous tissue. Overwhelming progression and difficulties in diagnosing are very common. Mortality rate is up to 100% depending on the type of soft tissue infection and did not markedly decrease in the past decades [1]. Here we present a case of NF with fatal outcome following colonoscopy, which was primarily suspected to be a post polypectomy syndrome.

scholarly journals Necrotizing Soft-Tissue Infection and Necrotizing Fasciitis in Adults of a Single Center: Review, Current Concepts and Challenges

2021 ◽  
pp. 1-9
Author(s):  
Constantinos Avgoustou ◽  
Constantinos Avgoustou ◽  
Periklis Constantinou ◽  
Christina Avgoustou ◽  
Karampas Vasilios ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Necrotizing Fasciitis ◽  
Organ Dysfunction ◽  
Soft Tissue Infection ◽  
Soft Tissues ◽  
Early Recognition ◽  
Tissue Infection ◽  
Necrotizing Soft Tissue Infection ◽  
Group I ◽  
Group Ii

Background: The aim of this work is to assess the clinical and therapeutic characteristics of patients treated for necrotizing soft-tissue infection/necrotizing fasciitis (NSTI/NF) and determine their outcomes. Patients and Methods: During the period 1/2012-12/2019 24 adults (18 males, 6 females, aged 33-91 years/mean age 52.4 years) with NSTI/NF were treated. Comorbidities were encountered in 20 (83.3%). Eighteen patients (Group I) presented late, with gangrene and systemic inflammatory response syndrome (9) or septic shock/ organ dysfunction (9). Six patients (Group II) presented early, with local pain, fever, and erythema. Affected areas included perineum-scrotum- external genitalia- abdominal wall or thigh, extremities-trunk, and gluteofemoral area in Group I, and scrotum, extremities, and labium majus in Group II. Results: Intensive resuscitation and antibiotics were started immediately. All patients had a CT scan and underwent surgery within 4 hours from admission. All necrotic soft tissues were aggressively excised. Additionally, patients underwent Hartmann’s colectomy (3) or colostomy (3), thoracostomy (1), opening of compartments of extremities (2), and extrapelvic drainage (1).Wounds were packed open; specimens were sent for Gram stain/cultures and histology. From Group I, 14 remained intubated for 2-10 days, and 15 required 1-5 further limited debridements or incisions (mean 2). Histologically, tissue necrosis was confirmed in all patients, NF in 18. Infection was polymicrobial in 20. Antibiotics were modulated based on culture results. Four Group I diabetics with extended perineal NF died due to uncontrolled sepsis (16.66%). Survivors received antibiosis for 10-18 days (mean, 15), were helped with nutritional support, and they had a planned wound closure or reconstruction. Their mean hospitalization was 28 days (range, 12-46). Conclusion: Improving diagnosis of NSTI/NF requires awareness for early recognition and prompt initiation of aggressive treatment, particularly for lesions extended beside perineum. Unfavourable outcome is affected by the delayed or inadequate surgery and the degree of multiple organ dysfunction on admission.

scholarly journals Study of the effectiveness of laboratory risk indicator for necrotizing fasciitis scoring system in the diagnosis of necrotizing fasciitis among patients presenting with soft tissue infections

2021 ◽  
Vol 8 (7) ◽  
pp. 2041
Author(s):  
Shreeniketan Nayak ◽  
Prakash S. Kattimani
Keyword(s):  
Soft Tissue ◽  
Necrotizing Fasciitis ◽  
Soft Tissue Infection ◽  
Scoring System ◽  
Tissue Infection ◽  
Risk Indicator ◽  
Soft Tissue Infections ◽  
Predictive Values ◽  
Necrotizing Soft Tissue Infection ◽  
Lrinec Score

Background: Necrotizing soft tissue infection (NSTI) is an uncommon but life threatening disease with a high mortality rate. Delay in diagnoses and in surgery for debridement is associated with increased mortality rates. Hence here we would like to use this scoring system - laboratory risk indicator for necrotizing fasciitis (LRINEC) in patients presenting to our hospital with necrotizing soft tissue infection and if found to have good predictive values, it would be a boon to developing countries like India where the mortality of the disease is high (7% to 76%).Methods: Patients presenting with symptoms suggestive of soft tissue infection underwent clinical examination and basic laboratory investigations. Following which, information collected using semi structured proforma cum observational checklist. LRINEC scoring system applied to each of the study subjects at admission. The confirmatory diagnosis of necrotizing fasciitis done on patients who undergo surgery vide histopathology, irrespective of the result of the LRINEC scoring system. Tissue cultures and sensitivity patterns analyzed.Results: A total of 100 patients were enrolled. LRINEC score has an ability to diagnose necrotizing fasciitis from other soft tissue infections. High LRINEC score had more incidences of features of sepsis. Presence of the co morbidities tended to increase the LRINEC score. And defines patients with a high LRINEC score of >8 had higher mortality rate.Conclusions: LRINEC score is a simple clinical tool for the diagnosis of necrotizing fasciitis from other soft tissue infections. LRINEC scoring system and clinical assessment should be used concurrently for diagnosing necrotizing fasciitis from other soft tissue infections.

scholarly journals Necrotizing Soft-Tissue Infections: Current Concepts and Challenges

2016 ◽  
Vol 6 (1) ◽  
pp. 1-2
Author(s):  
Avgoustou C ◽  
Avgoustou Ch
Keyword(s):  
Soft Tissue ◽  
Infectious Diseases ◽  
Necrotizing Fasciitis ◽  
Soft Tissue Infection ◽  
Tissue Infection ◽  
Soft Tissue Infections ◽  
Necrotizing Soft Tissue Infection ◽  
Yearly Incidence ◽  
Necrotizing Soft Tissue Infections

Necrotizing Soft-Tissue Infection (NSTI) and the most fulminant form of it, Necrotizing Fasciitis (NF), are rather uncommon but severe and destructive infectious diseases with high rates of mortality. Yearly incidence is reported to be 0.4 cases per 100,000 habitats, while reported mortality ranges from 21% to 43% [1].

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