Necrotizing Fasciitis: Everything You Need To Know
What we know as necrotizing fasciitis has other names as well, such as Fournier’s gangrene or gas gangrene . It represents a highly lethal clinical picture that puts the health of those who suffer from it at risk.
It is a soft tissue infection that kills cells in the skin, the subcutaneous cell layer, and even the muscles. The bacteria that promote this cell death move at great speed and make initial diagnosis difficult.
Microorganisms enter the deeper layers of the skin through a small wound or opening. Once inside, they multiply in various ways: some produce toxins and others mobilize the immune system.
Among patients with necrotizing fasciitis who undergo surgery, mortality reaches more than 20%. Mortalities of 40% have been recorded in some series, denoting high fatality.
In children it does not usually appear ; it is considered a rarity in pediatrics. Rather, the risk groups are adults with chronic diseases such as diabetes and cancer.
Symptoms of necrotizing fasciitis
Necrotizing fasciitis progresses quietly at first, which can delay diagnosis and complicate the course and prognosis. The first symptoms do not tend to guide what is happening.
Patients suffer from fever, which can be attributed to other causes when the check-up is done. The pain in the area where the bacteria entered is very powerful, but it does not appear immediately. The painful sign becomes evident when cell death is advanced.
The nerves in that area become inflamed and even infarcted. In autopsies of deceased patients, thrombosis of the small vessels surrounding the necrotizing fasciitis infection has been found.
Sepsis occurs when bacteria or their toxins reach the bloodstream and spread through the body. Once the pathological evolution progresses to sepsis, the symptoms will be those of shock :
Faintness.
Loss of consciousness
Increased heart rate.
Arterial hypotension
The area of the skin with necrotizing fasciitis also progresses to more complex lesions. Some patients have bruises and other blisters. A classic sign is crepitus, which is the sound that is produced when the region is palpated by the gas that bacteria deposit under the dermal tissue.
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