Related Experiment Video
Updated: Mar 13, 2026
Competing-Risk Nomogram for Predicting Cancer-Specific Survival in Multiple Primary Colorectal Cancer Patients after Surgery
Published on: September 27, 2024
Synchronous multifocal necrotizing fasciitis prognostic factors: a retrospective case series study in a single center
Ching-Yu Lee1,2,3, Yen-Yao Li1, Tsan-Wen Huang1,3
1Department of Orthopedic Surgery, Chang Gung Memorial Hospital, No. 6, West Sec., Jiapu Road, Puzi City, Chiayi, 613, Taiwan.
Purpose:
No reports have been published on synchronous multifocal necrotizing fasciitis (SMNF), a multifocal presence of necrotizing fasciitis in different extremities. We evaluated the clinical characteristics and outcomes of SMNF.
Methods:
Eighteen patients (14 men, 4 women; mean age: 59 years) diagnosed with SMNF of the extremities between January 2004 to December 2012 were enrolled and evaluated.
Results:
Vibrio species were the most commonly (78%; n = 14) isolated; others were two cases (11%) of Aeromonas spp., one case (6%) of group A β-hemolytic streptococcus, and one case of coagulase-negative staphylococcus. SMNF was in the bilateral lower limbs (72%; n = 13), bilateral upper limbs (17%; n = 3), and one patient with one upper and one lower limb (11%). Non-surviving patients had more bilateral lower limb involvement and thrombocytopenia.
Conclusions:
Most patients with SMNF were male and had bilateral lower limb and marine Gram-negative bacteria involvement. The mortality of SMNF remained extremely high in patients with involvement of bilateral lower limb and initial thrombocytopenia.
Insights
Synchronous multifocal necrotizing fasciitis (SMNF) predominantly affects males, often involving lower limbs and marine bacteria. High mortality is linked to bilateral lower limb involvement and low platelet counts.
Area of Science:
- Infectious Diseases
- Dermatology
- Surgery
Background:
- Necrotizing fasciitis is a severe bacterial infection.
- Synchronous multifocal necrotizing fasciitis (SMNF) is a rare variant affecting multiple extremities.
- Limited data exists on SMNF's clinical presentation and outcomes.
Purpose of the Study:
- To describe the clinical characteristics of SMNF.
- To evaluate patient outcomes in SMNF.
- To identify factors associated with mortality in SMNF.
Main Methods:
- Retrospective evaluation of 18 patients diagnosed with SMNF between 2004-2012.
- Analysis of patient demographics, clinical presentation, microbial isolates, and treatment outcomes.
- Comparison of characteristics between survivors and non-survivors.
Main Results:
- The most common pathogen was Vibrio species (78%).
- Bilateral lower limb involvement was most frequent (72%).
- Non-survivors showed increased bilateral lower limb involvement and thrombocytopenia.
Conclusions:
- SMNF commonly affects males and is associated with marine Gram-negative bacteria.
- High mortality in SMNF is associated with bilateral lower limb involvement and initial thrombocytopenia.
- Further research is needed to understand and manage this severe condition.
Related Concept Videos
01:26Factors Affecting the Risk of Infection
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin...
01:28Acute Pyelonephritis II: Diagnostic Studies and Management