Necrotizing cellulitis: Difference between revisions
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*Pts are often much less toxic compared with nec fasc/nec myo | *Pts are often much less toxic compared with nec fasc/nec myo | ||
* 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 pts | ***Rare infection that occurs in postop pts | ||
Revision as of 17:14, 6 April 2014
Background
- Pts are often much less toxic compared with nec fasc/nec myo
- Two types:
- Anaerobic infection (clostridial and nonclostridial)
- Meleney's synergistic gangrene
- Rare infection that occurs in postop pts
- 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)
Workup
Management
- Same as Necrotizing Fasciitis