Related Experiment Video
Updated: Aug 11, 2026
Live Imaging of Antifungal Activity by Human Primary Neutrophils and Monocytes in Response to A. fumigatus
Published on: April 19, 2017
Necrotizing fasciitis: a clinical, microbiologic, and histopathologic study of 14 patients
I J Umbert1, R K Winkelmann, G F Oliver
1Department of Dermatology, Mayo Clinic, Rochester, MN 55905.
Abstract:
We studied the clinical, microbiologic, and histopathologic findings from 14 patients with necrotizing fasciitis; also tissue obtained at autopsy was available from six patients. In all cases, material cultured was positive for multiple organisms, including Clostridia and fungi; organisms were identified by histochemical staining of tissue sections in 12 of 14 cases. The histologic pattern comprised edema, necrosis, and inflammation of skin, subcutaneous fat, and fascial tissue. Hyalin necrosis of sweat glands was observed in five patients. Thrombosis of vessels at all levels was a prominent feature, suggesting that study of coagulation factors may be important. Diagnosis may be confirmed by the histologic picture; however, microbiologic material is essential to guide therapy.
Insights
Necrotizing fasciitis involves multiple organisms and tissue damage. Histopathology aids diagnosis, but microbiology is crucial for guiding effective treatment strategies.
Area of Science:
- Infectious Diseases
- Pathology
- Dermatology
Background:
- Necrotizing fasciitis is a severe soft tissue infection.
- Early diagnosis and treatment are critical for patient outcomes.
Purpose of the Study:
- To analyze the clinical, microbiologic, and histopathologic features of necrotizing fasciitis.
- To correlate histopathologic findings with causative organisms and clinical presentation.
Main Methods:
- Retrospective review of 14 patients with necrotizing fasciitis.
- Analysis of clinical data, microbiologic cultures, and histopathologic examination of tissue samples.
- Histochemical staining for organism identification in tissue sections.
Main Results:
- Multiple organisms, including Clostridia and fungi, were identified in all cultures.
- Histologic findings included edema, necrosis, inflammation, and vascular thrombosis.
- Hyaline necrosis of sweat glands was noted in 5/14 patients.
- Histologic diagnosis was confirmed in 12/14 cases.
Conclusions:
- Histopathology provides diagnostic clues for necrotizing fasciitis.
- Microbiologic identification is essential for targeted antimicrobial therapy.
- Vascular thrombosis is a significant feature, suggesting a role for coagulation studies.
