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Necrotizing Soft Tissue Infections

Thomas M. File1

  • 1Northeastern Ohio Universities College of Medicine, Rootstown, OH, and Summa Health System, 75 Arch Street, Suite 105, Akron, OH 44304, USA. filet@summa-health.org

Current Infectious Disease Reports
|September 19, 2003
PubMed

Insights

Necrotizing soft tissue infections, particularly necrotizing fasciitis caused by group A Streptococcus, have high mortality rates. Intravenous immunoglobulin may allow delayed surgery by neutralizing superantigens, improving patient outcomes.

Area of Science:

  • Infectious Diseases
  • Microbiology
  • Surgery

Background:

  • Necrotizing soft tissue infections (NSTIs) present with skin and associated structure necrosis.
  • Despite diagnostic and therapeutic advances, NSTIs are associated with high mortality rates.
  • Group A Streptococcus (GAS) is increasingly reported as a cause of necrotizing fasciitis (NF).

Purpose of the Study:

  • To review the pathogenesis and management of necrotizing soft tissue infections.
  • To highlight the role of superantigens in GAS necrotizing fasciitis.
  • To discuss the potential role of intravenous immunoglobulin in managing these infections.

Main Methods:

  • Literature review of necrotizing soft tissue infections.
  • Analysis of recent reports on group A Streptococcus necrotizing fasciitis.
  • Evaluation of treatment strategies including surgery, antimicrobials, and immunoglobulin therapy.

Main Results:

  • Necrotizing soft tissue infections are severe infections with high mortality.
  • Superantigens play a significant role in the pathogenesis of GAS necrotizing fasciitis.
  • Early surgical debridement and antimicrobial agents are crucial for management.

Conclusions:

  • Prompt evaluation and intervention are critical for managing necrotizing soft tissue infections.
  • Intravenous immunoglobulin may offer a strategy to neutralize superantigens and potentially allow for delayed surgical debridement in select patients.
  • Further research is needed to establish the role of intravenous immunoglobulin in the management of these severe infections.

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