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Necrotizing Fasciitis

Necrotizing Fasciitis. ALTIN VESELI. What is Necrotizing Fasciitis?. Hippocrates in the 15th century BC, spoke of it as a complication of erysipelas. Flesh eating bacteria Group A streptococcus(Streptococcus pyogenes), Staphylococcus aureus, Clostridium perfringens .

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Necrotizing Fasciitis

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  1. Necrotizing Fasciitis ALTIN VESELI

  2. What is Necrotizing Fasciitis? • Hippocrates in the 15th century BC, spoke of it as a complication of erysipelas. • Flesh eating bacteria • Group A streptococcus(Streptococcus pyogenes), Staphylococcus aureus, Clostridium perfringens. • Type 1 (Polymicrobial),Type 2 (Monomicrobial)

  3. Erysipelas:Red Skin

  4. How does it work? • Bacteria enter the body through a break in the skin • Paper cuts, Scrape, Burn, Surgical wound. • Progresses very rapidly • Immunosuppressed individuals(diabetics, elderly, liver disease, AIDS,chemotherapy) • Healthy, strong immune system, practice good hygiene and proper wound care.

  5. Diagnosis • The Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score • It uses 6 serologic measures: C-reactive protein, total WBC count, hemoglobin, creatinine and glucose. • <6 indicates that necrotizing fasciitis should seriously be considered. • >6 Higher rate of mortality and amputation.

  6. Symptoms • Similar and difficult to differentiate from cellulitis • Severe pain in the affected area. • Redness, Swelling, Hot skin • Fever, Chills, Fatigue may follow the initial wound or soreness. • Skin discoloration(violet), blisters, discharge of dish-water like fluid.

  7. Patient developed rapidly progressive painful erythema and edema following a bee sting. Necrotizing fasciitis was diagnosed.

  8. Patient in the healing process

  9. Treatment • Early diagnosis=Early treatment • Intravenous antibiotic therapy(piperacillin/tazobactam, vancomycin, and clindamycin) • Intravenous immunoglobulin • Surgery(depridement) • Amputation of affected limb • Hyperbaric oxygen therapy

  10. Notable cases • 2004: Eric Allin Cornell, winner of the 2001 Nobel Prize in Physics, lost his left arm and shoulder to the disease. • 2012: Aimee Copeland, a 24-year-old graduate student, contracted necrotizing fasciitis after she fell from a zip-line into the Little Tallapoosa River which caused a deep cut in her leg. Copeland’s entire leg was amputated along with her other limbs as a side effect of the disease and treatment. Five of her organs also failed as a result of the ordeal.

  11. References • https://en.wikipedia.org/wiki/Necrotizing_fasciitis • http://www.cdc.gov/features/necrotizingfasciitis/ • http://www.medscape.com/viewarticle/444061_4 • http://www.medicinenet.com/necrotizing_fasciitis/page3.htm

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