Clinico-microbiological profile of necrotizing fasciitis secondary to diabetes mellitus in a tertiary care hospital

Mathew, Alvin and Mridula, M and Vishwanath, Shashidhar and Mukhopadhyay, Chiranjay (2010) Clinico-microbiological profile of necrotizing fasciitis secondary to diabetes mellitus in a tertiary care hospital. GENERAL SURGERY, 1 (12). pp. 1-11.

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Abstract

Objectives: Necrotizing fasciitis is a life-threatening soft-tissue infection primarily involving the superficial fascia. The present study describes the clinical presentation and microbiological characteristics of this condition as well as risk factors, management and outcome of the patients. Materials and Methods: In this prospective study, tissue and/or wound swabs and blood for culture from 50 clinically suspected cases were cultured aerobically and anaerobically and the isolates tested for sensitivity. Clinical correlation and follow-up was done. Results: The age range was 17-87 years (mean=54 yrs) with a male predominance. The most common site of infection was the calf region (59.5%) and diabetes mellitus was the most common associated comorbidity (44.7%). Majority of the patients presented with symptoms of sepsis, systemic toxicity, or evidence of skin inflammation. Hyperacute cases presented with sepsis and quickly progressed to multiorgan failure (40%). 23 patients (57.5%) had microbiological isolates and in 16% of the cases, there was an anaerobic growth. Staphylococcus aureus and Klebsiella pneumonia were the most common isolates, whereas Pseudomonas aeruginosa was the most common environmental strains, suggestive to be colonizer. Antibiotics were instituted in all patients and all required debridement. Amputation had to be done in 2 patients. 21.3% of the patients were admitted in the ICU. Most of the patients recovered on treatment. Conclusions: Necrotizing fasciitis is a common condition that results in gross morbidity and mortality if not treated at early stages. A high index of suspicion is important in view of the paucity of the specific cutaneous findings early in the course of the disease.

Item Type: Article
Uncontrolled Keywords: Necrosis, fasciitis, debridement, antibiotics, mortality, morbidity
Subjects: Medicine > KMC Manipal > Microbiology
Medicine > KMC Manipal > Surgery
Depositing User: KMC Manipal
Date Deposited: 15 Jun 2011 05:15
Last Modified: 15 Jun 2011 05:15
URI: http://eprints.manipal.edu/id/eprint/276

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