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Necrotizing fasciitis أبريل 2023 - Coggle Diagram
Necrotizing fasciitis
أبريل 2023
Definition
Necrotizing fasciitis is a severe and life-threatening bacterial infection that affects the deep layers of the skin, including the fascia, muscles, and surrounding tissues. It is commonly referred to as a "flesh-eating" infection because it rapidly destroys the affected tissues.
Causes
Group A Streptococcus (GAS) and methicillin-resistant Staphylococcus aureus (MRSA). These bacteria can enter the body through a break in the skin, such as a cut, wound, or surgical incision.
Treatment
Supportive care:
as IV fluids, pain management, and intensive care monitoring.
Antibiotics: IV Abs as broad-spectrum Abs or specific Abs targeted at the identified bacteria, are administered to combat the infection.
Surgical intervention: Prompt surgical exploration and debridement are essential to remove the infected and necrotic tissue.
Hyperbaric oxygen therapy: may be used to increase oxygen delivery to the tissues and inhibit bacterial growth.
Investigations
Laboratory tests:
Elevated WBCs count,
Elevated inflammatory markers (such as CRP and ESR), - - Blood cultures may help identify the causative bacteria.
Imaging tests: X-rays, US, or MRI can help visualize the extent of tissue involvement and assess for gas formation.
Tissue biopsy: A small sample of the affected tissue may be taken for microscopic examination and culture to identify the specific bacteria involved.
DD
Cellulitis: Cellulitis is a bacterial infection of the skin that causes redness, swelling, and pain. It is less severe than NF and does not involve the deeper layers of skin and tissue.
Abscess: An abscess is a localized infection that forms a pus-filled pocket in the skin. It can be caused by bacteria, fungi, or viruses and is less severe than NF.
Fournier's gangrene: Fournier's gangrene is a type of NF that affects the genital and perineal area. It is more common in men and is often associated with diabetes, HIV, or other underlying medical conditions.
Diabetic foot infection: Diabetic foot infection is a bacterial infection that affects people with diabetes. It can lead to tissue damage, ulcers, and in severe cases, NF.
Traumatic injury: Trauma, such as a deep cut, puncture wound, or crush injury, can lead to NF if bacteria enter the wound.
Radiation dermatitis: Radiation therapy can cause skin irritation, redness, and pain. In some cases, it can lead to NF, especially in patients with underlying medical conditions.
Malignancy: In rare cases, NF can be a sign of underlying malignancy, such as cancer or lymphoma.
DVT
Complications:
Organ faliure: If the infection becomes widespread, it can affect various organs, leading to their failure.
Gangrene: The affected tissues may become necrotic and develop gangrene, which require surgical removal.
Sepsis: The infection can spread throughout the body, causing a systemic inflammatory response and organ failure.
Toxic shock syndrome: In severe cases, necrotizing fasciitis can result in toxic shock syndrome, characterized by a severe drop in blood pressure, organ failure, and potentially death.
Clinical Features:
Systemic symptoms like fever, chills, nausea, vomiting, and general malaise.
Formation of blisters, ulcers, or black spots on the skin.
Redness, swelling, and warmth of the skin.
Severe pain and tenderness around the affected area, which may progress rapidly.
Rapid progression of the infection, with the affected area becoming increasingly swollen, discolored, and necrotic.