Necrotizing fasciitis: a life-threatening infection

Necrotizing fasciitis is a rapidly progressing, synergistic bacterial infection of fascia with a reported average mortality of about 40%. Fournier's disease, necrotizing fasciitis of the genital sphere, is also included in this study. Seven patients were studied over a one-year period between May 1991 and October 1992. Most commonly, they were infected by perineal diseases, medical procedures and cutaneous ulcers. The local clinical signs are cellulitis, oedema, blisters, necrosis and crepitus; general septic symptoms may also be present. Associated chronic diseases were present in 4 patients. Three infections were polymicrobial. Control of this potentially lethal soft-tissue infection is based on early clinical diagnosis, timely, wide surgical debridements and appropriate antibiotic treatment. The overall mortality rate was 1 of 7 (14%). Death was due to persistent wound sepsis and systemic septic complications, but mainly to delay in surgical treatment. The presence of chronic debilitating diseases (diabetes, alcohol abuse, renal insufficiency, ...) contribute to increase rate of both local and systemic infection.