NECROTIZING FASCIITIS - A LIFE-THREATENING INFECTION

Necrotizing fasciitis is a rapidly progressing, synergistic bacterial infection of fascia with a reported average mortality of about 40%. Fo urnier's disease, necrotizing fasciitis of the genital sphere, is also included in this study. Seven patients were studied over a one-year p eriod between May 1991 and October 1992. Most commonly, they were infe cted by perineal diseases, medical procedures and cutaneous ulcers. Th e local clinical signs are cellulitis, oedema, blisters, necrosis and crepitus; general septic symptoms may also be present. Associated chro nic diseases were present in 4 patients. Three infections were polymic robial. Control of this potentially lethal soft-tissue infection is ba sed on early clinical diagnosis, timely, wide surgical debridements an d appropriate antibiotic treatment. The overall mortality rate was 1 o f 7 (14%). Death was due to persistent wound sepsis and systemic septi c complications, but mainly to delay in surgical treatment. The presen ce of chronic debilitating diseases (diabetes, alcohol abuse, renal in sufficiency,...) contribute to increase rate of both local and systemi c infection.