[Necrotizing fasciitis of the upper limb. 12 cases]

Twelve cases of necrotizing fasciitis or streptococcal cellulitis of the upper limb are reported. Four cases presented with a low grade aggressive for and one case was chronic. Seven fulminating cases resulted in two deaths. These different presentations are in fact different stages of the same disease which is a group A beta-hemolytic streptococcal necrotizing infection of the subcutaneous tissue. It is a medical emergency in which surgery is the main treatment. In cases seen early, surgery helps by making an early diagnosis by showing the typical appearance of the subcutaneous tissue and by isolating organisms in wound culture. In fulminant cases, only extensive surgical debridement can control infection. Delayed or incomplete radical excision may lead to disseminated infection. Infection spreading beyond one upper limb worsens the vital prognosis.