Necrotizing cellulitis: Difference between revisions
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==Background== | ==Background== | ||
* | *Patients are often much less toxic compared with necrotizing fasciitis/necrotizing myositis | ||
* Two types: | *Two types: | ||
**[[Anaerobic]] infection (clostridial and nonclostridial) | **[[Anaerobic]] infection (clostridial and nonclostridial) | ||
**Meleney's synergistic gangrene | **Meleney's synergistic gangrene | ||
***Rare infection that occurs in postop | ***Rare infection that occurs in postop patients | ||
***Characterized by slowly expanding indolent ulceration that is confined to superficial fascia | ***Characterized by slowly expanding indolent ulceration that is confined to superficial fascia | ||
***Results from synergistic interaction between S. aureus and microaerophilic streptococci | ***Results from synergistic interaction between S. aureus and microaerophilic streptococci | ||
| Line 18: | Line 18: | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
{{ | {{SSTI DDX}} | ||
{{Necrotizing Rashes DDX}} | |||
==Evaluation== | |||
==Management== | ==Management== | ||
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==Disposition== | ==Disposition== | ||
Admit/OR | *Admit/OR | ||
==See Also== | ==See Also== | ||
*[[Necrotizing | *[[Necrotizing soft tissue infections]] | ||
== | ==References== | ||
<references/> | <references/> | ||
[[Category:ID]] | |||
Latest revision as of 05:33, 28 July 2016
Background
- Patients are often much less toxic compared with necrotizing fasciitis/necrotizing myositis
- Two types:
- Anaerobic infection (clostridial and nonclostridial)
- Meleney's synergistic gangrene
- Rare infection that occurs in postop patients
- Characterized by slowly expanding indolent ulceration that is confined to superficial fascia
- Results from synergistic interaction between S. aureus and microaerophilic streptococci
Risk Factors
- Trauma
- Surgical contamination
- Spread of infection from bowel to perineum, abdominal wall, or lower extremities
Clinical Features
- Thin, dark, sometimes foul-smelling wound drainage (often containing fat globules)
- Tissue gas formation (crepitus)
Differential Diagnosis
Skin and Soft Tissue Infection
- Cellulitis
- Erysipelas
- Lymphangitis
- Folliculitis
- Hidradenitis suppurativa
- Skin abscess
- Necrotizing soft tissue infections
- Mycobacterium marinum
Look-A-Likes
- Sporotrichosis
- Osteomyelitis
- Deep venous thrombosis
- Pyomyositis
- Purple glove syndrome
- Tuberculosis (tuberculous inflammation of the skin)
Necrotizing rashes
- Necrotizing soft tissue infections
- Purpura fulminans
- Drug rash
- Levamisole toxicity
- Heparin-induced skin necrosis
- Warfarin-induced skin necrosis
Evaluation
Management
- Same as Necrotizing Fasciitis
Disposition
- Admit/OR