Table of Contents
ISRN Infectious Diseases
Volume 2014 (2014), Article ID 208072, 8 pages
http://dx.doi.org/10.1155/2014/208072
Review Article

Necrotizing Fasciitis: Diagnostic Challenges and Current Practices

Department of General Surgery, Victoria Hospital, Bangalore Medical College and Research Institute, Bangalore, Karnataka 560002, India

Received 12 November 2013; Accepted 5 December 2013; Published 22 January 2014

Academic Editors: E. Çiftçi and R. Favory

Copyright © 2014 Abhishek Vijayakumar et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Necrotizing fasciitis or necrotizing soft-tissue infections (NSTIs) are infrequent but highly lethal infections. They can be defined as infections of any of the layers within the soft tissue compartment (dermis, subcutaneous tissue, superficial fascia, deep fascia, or muscle) that are associated with necrotizing changes. At onset, necrotizing fasciitis can be difficult to differentiate from cellulitis and other superficial infections of the skin. In fact, only 15% to 34% of patients with necrotizing fasciitis have an accurate admitting diagnosis. Early diagnosis and management with surgical debridement, antimicrobials, and supportive measures reduce mortality. Even with modern ICU care mortality ranges between 16 and 36%; this is related to delays in diagnosis and comorbidities. Various scoring systems have been developed which help in diagnosis and stratifying patients into risk groups. The present review deals with varied presentation, early diagnosis, and management of necrotizing fasciitis.