TY - JOUR
T1 - Necrotizing fasciitis
T2 - A challenging diagnosis
AU - Hefny, Ashraf F.
AU - Eid, Hani O.
AU - Al-Hussona, Mudher
AU - Idris, Kamal M.
AU - Abu-Zidan, Fikri M.
PY - 2007/2
Y1 - 2007/2
N2 - The objective of the study was to evaluate our recent experience in diagnosis and management of necrotizing fasciitis. Records of patients who were diagnosed as having necrotizing fasciitis at Al-Ain Hospital in the period between March 2003 and August 2005 were studied retrospectively with regard to clinical features, risk factors, diagnosis, causative organisms, treatment, and outcome. Eleven patients, eight of whom were men of low socio-economic status, were studied. The median age (range) was 46 (8-65) years. The main risk factor was diabetes mellitus in seven patients (64%). The provisional clinical diagnosis was incorrect in seven patients (64%). Pure β-hemolytic streptococcus group A or B was the cousative organism in five patients (46%). Most of our patients underwent multiple surgical debridements with a median range of two (1-11) operations. Two patients died (overall mortality rate 18%). High clinical suspicion is essential for the diagnosis of necrotizing fasciitis. Accurate early diagnosis, aggressive resuscitation, using proper antibiotics, and extensive surgical debridement are essential for a favorable outcome.
AB - The objective of the study was to evaluate our recent experience in diagnosis and management of necrotizing fasciitis. Records of patients who were diagnosed as having necrotizing fasciitis at Al-Ain Hospital in the period between March 2003 and August 2005 were studied retrospectively with regard to clinical features, risk factors, diagnosis, causative organisms, treatment, and outcome. Eleven patients, eight of whom were men of low socio-economic status, were studied. The median age (range) was 46 (8-65) years. The main risk factor was diabetes mellitus in seven patients (64%). The provisional clinical diagnosis was incorrect in seven patients (64%). Pure β-hemolytic streptococcus group A or B was the cousative organism in five patients (46%). Most of our patients underwent multiple surgical debridements with a median range of two (1-11) operations. Two patients died (overall mortality rate 18%). High clinical suspicion is essential for the diagnosis of necrotizing fasciitis. Accurate early diagnosis, aggressive resuscitation, using proper antibiotics, and extensive surgical debridement are essential for a favorable outcome.
KW - Diagnosis
KW - Gangrene
KW - Necrotizing fasciitis
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U2 - 10.1097/01.mej.0000228447.48276.7b
DO - 10.1097/01.mej.0000228447.48276.7b
M3 - Article
C2 - 17198329
AN - SCOPUS:33846006583
SN - 0969-9546
VL - 14
SP - 50
EP - 52
JO - European Journal of Emergency Medicine
JF - European Journal of Emergency Medicine
IS - 1
ER -