Necrotizing Fasciitis: A Clinical and Microbiological Study
Author(s): J Magesh Kumar, RNM Francis and V Ramalakshmi*
Abstract
Objective: Necrotizing fasciitis (NF) is a prolong inflammation of the soft tissue and prevalent with higher morbidity and mortality. The treatment would be based on the surgical debridement and antibiotic therapies.
Methods: All cases of Necrotizing fasciitis admitted in Sree Balaji Medical College & Hospital, Chennai-44 between the period of November 2014 and October 2016 were included in the study. The diagnosis was made by combination of clinical and gross anatomical findings, biochemical characterization, and microbiological evaluation.
Results: The male predominance was found among the patients. The pain was presented as most common symptom (95%) and mean duration was 10.08 days. Trauma contributed as most common etiological factors (30%) and Diabetes mellitus was the most common associate comorbid condition (38.3%) in patients, followed by hypertension in 18 patients (30%). The culture was monomicrobial in 37 (61.7%) patients, polymicrobial in 22 (36.7%) patients and sterile in 1.7% of patients. 86.7% of isolates were aerobic and 13.3% were anaerobic in nature. E. coli was the commonest bacteria among the patients.
Conclusions: In severe cases the combination of necrotic skin and soft tissue gas facilitates the correct diagnosis, which should than be followed by immediate - and most often-repeated debridement. The anaerobes are isolated an early and aggressive second look is necessary. The finding of the study would be especially useful for therapeutic planning.