Necrotizing fasciitis is associated with a high mortality rate and should be treated immediately upon identification in the emergency department. Patients may present with different clinical histories and physical exam findings, but it is important that necrotizing fasciitis be ruled out in cases of rapidly progressive soft tissue infections.
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ACEP Now: Vol 37 – No 10 – October 2018Dr. Peña is an emergency medicine resident at St. Joseph’s University Medical Center in Paterson, New Jersey.
Dr. Bella is an emergency medicine resident at Morristown Medical Center in Morristown, New Jersey.
References
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- Wong CH, Chang HC, Pasupathy S, et al. Necrotizing fasciitis: clinical presentation, microbiology, and determinants of morality. J Bone Joint Surg Am. 2003;85-A(8):1454-1460.
- Neeki MM, Dong F, Au C, et al. Evaluating the Laboratory Risk Indicator to differentiate cellulitis from necrotizing fasciitis in the emergency department. West J Emerg Med. 2017;18(4): 684-689.
- Wong CH, Khin LW, Heng KS, et al. Clinical relevance of the LRINEC (Laboratory Risk Index for Necrotizing Fasciitis) score for assessment of early necrotizing fasciitis. Crit Care Med. 2005;32(7):1535-1541.
- Panesar K. Necrotizing soft-tissue infections: “flesh-eating bacteria.” US Pharm. 2013;38(4):HS8-HS12.
- Misiakos EP, Bagias G, Papadopoulos I, et al. Early diagnosis and surgical treatment for necrotizing fasciitis: a multicenter study. Front Surg. 2017;4:5.
- Kleshinski J, Bittar S, Wahlquist M, et al. Review of compartment syndrome due to group A streptococcal infection. Am J Med Sci. 2008;336(3):265-269.
- Johnson P, Ocksrider J, Silva S. Update and review of acute compartment syndrome and necrotizing fasciitis. Intern Med Rev. 2017; 3(2).
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