This document discusses necrotizing soft tissue infections such as necrotizing fasciitis. It notes that these infections can originate from trauma, surgery, immunosuppression or malignancy. They can be polymicrobial, involving multiple organisms, or monomicrobial, involving an aggressive single organism. Diagnosis involves history, examination, and imaging tests. Differential diagnoses include deep vein thrombosis, pyomyositis, pyoderma gangrenosum, and cellulitis. Treatment involves stabilization, broad spectrum antibiotics, debridement of infected tissue, and reconstruction.

1. Nectrotizing
soft tissue
infection
Hassan Al Wtayyan

2. •Necrotizing fasciitis : extending through the
deep fascia below the subcutaneous layers
•Fournier’s gangrene: originates in the perineum.
•Clostridial myonecrosis:extend into the
deep muscle compartments, causing
muscular necrosis.
synonyms

3. trauma
surgery
Immunosuppression
Malignancy
Obesity
Alcoholism
Risk factors

5. polymicrobial
• 75%
• four organisms
• less lethal.
Monomicrobial
• Aggressive
• acute onset
marine
Vibrio (sea water)
Aeromonas
(freshwater)
fungal
Immunosuppression

6. Diagnosis
• Proper history
• Proper examination
Clinically
1
• Non specific
• Necrotizing Fasciitis
Score System
investigation
2
• X ray
• CT / MRI
Imaging
3

10. DVT
characterized by extremity swelling,
pain, and warmth; the pain is less
extreme than in the setting of
necrotizing infection.
Pyomyositis
abscess formation in skeletal
muscle, while necrotizing myositis is
characterized by gangrenous
necrosis.
Pyoderma gangrenosum
strongest associations are between
PG and inflammatory bowel
disease, hematologic disorders, and
arthritis
Cellulitis
presents with skin erythema, edema, and
warmth. Fever may be present, but cellulitis
is generally not associated with
hemodynamic instability.
DIFFERENTIAL DIAGNOSIS
1
2
3
4

11. stabilization
Adjunct
• Hyperbaric oxygen therapy
• Intravenous immunoglobulin
• Plasmapheresis.
1
Broad spectrum Abx
2
Debridement
3 Reconstruction