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Soft Tissue Tumors

Infections, inflammation and hematomas

Necrotizing fasciitis


Reviewer: Komal Arora, M.D. (see Reviewers page)
Revised: 18 July 2012, last major update July 2012
Copyright: (c) 2003-2012, PathologyOutlines.com, Inc.

General
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● Uncommon fulminant soft tissue infection characterized by extensive fascial necrosis
● Usually due to group A streptococci, also community-acquired MRSA (Surg Infect (Larchmt) 2008;9:469)
● May be due to Clostridium perfringens and cause gas gangrene (Cases J 2008 Oct 20;1(1):252)

Clinical features
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● Fatal if untreated
● 15% mortality even if treated (Epidemiol Infect 2009;137:1609)
● Particularly serious in patients with badly controlled diabetes (Diabetes Res Clin Pract 2008;80:218)

Treatment
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● Promptly start antibiotics and aggressive debridement (World J Emerg Surg 2007;2:19, J Am Acad Orthop Surg 2009;17:174)

Case reports
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● Due to Pseudomonas (Intern Med 2008;47:553)

Clinical images
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Gas gangrene


Right shoulder


Left leg

Micro images
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Infected tissue with gas-inclusion between the muscle fibers


Gram positive rods

Gluteal gas gangrene with necrotizing fasciitis #1, #2

Gas gangrene #1, #2

Necrotic muscle with gas bubbles but minimal inflammation

Leg lesion

Necrotizing fasciitis and panniculitis (pneumococci) #1, #2

Pneumococcal sepsis #1, #2

Septic thrombus

Associated vasculitis

Gram stain #1, #2, #3

Additional references
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eMedicine #1, #2
J Trauma Acute Care Surg 2012;72:560

End of Soft Tissue Tumors > Infections, inflammation and hematomas > Necrotizing fasciitis


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