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Wei X, Huo J, Yang Q, Li J. Early diagnosis of necrotizing fasciitis: Imaging techniques and their combined application. Int Wound J 2024; 21:e14379. [PMID: 37679292 PMCID: PMC10784425 DOI: 10.1111/iwj.14379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 08/24/2023] [Indexed: 09/09/2023] Open
Abstract
Necrotizing fasciitis is a clinical, surgical emergency characterized by an insidious onset, rapid progression, and a high mortality rate. The disease's mortality rate has remained high for many years, mainly because of its atypical clinical presentation, which prevents many cases from being diagnosed early and accurately, resulting in patients who may die from uncontrollable septic shock and multi-organ failure. But unfortunately, no diagnostic indicator can provide a certain early diagnosis of NF, and clinical judgement of NF is still based on the results of various ancillary tests combined with the patient's medical history, clinical manifestations, and the physician's experience. This review provides a brief overview of the epidemiological features of NF and then discusses the most important laboratory indicators and scoring systems currently employed to diagnose NF. Finally, the latest progress of several imaging techniques in the early diagnosis of NF and their combined application with other diagnostic indices are highlighted. We point out promising research directions based on an objective evaluation of the advantages and shortcomings of different methods, which provide a basis for further improving the early diagnosis of NF.
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Affiliation(s)
- Xin‐ke Wei
- Department of Burns and Plastic SurgerySecond Affiliated Hospital of Air Force Military Medical UniversityXi'anChina
| | - Jun‐yi Huo
- Department of Burns and Plastic SurgerySecond Affiliated Hospital of Air Force Military Medical UniversityXi'anChina
| | - Qin Yang
- Department of Burns and Plastic SurgerySecond Affiliated Hospital of Air Force Military Medical UniversityXi'anChina
| | - Jing Li
- Department of Burns and Plastic SurgerySecond Affiliated Hospital of Air Force Military Medical UniversityXi'anChina
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Yoon JP, Jung YS, Kim DH. Local myofascitis of the deltoid muscle after administration of the AstraZeneca (AZD1222) COVID-19 vaccine: two cases, infectious and inflammatory. JSES REVIEWS, REPORTS, AND TECHNIQUES 2022; 2:376-379. [PMID: 35571584 PMCID: PMC9085349 DOI: 10.1016/j.xrrt.2022.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Jong Pil Yoon
- Department of Orthopaedic Surgery, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Young Soo Jung
- Department of Orthopaedic Surgery, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Dong Hyun Kim
- Department of Orthopaedic Surgery, School of Medicine, Kyungpook National University, Daegu, Korea
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Matsuki J, Ishigami A, Tanaka M, Hata S, Ishida Y, Nosaka M, Kuninaka Y, Yamamoto H, Shimada E, Hashizume Y, Takayasu T, Kimura A, Furukawa F, Kondo T. A case of necrotizing fasciitis following intra-articular injections - Iatrogenic or spontaneous? Leg Med (Tokyo) 2021; 54:101989. [PMID: 34798589 DOI: 10.1016/j.legalmed.2021.101989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 10/25/2021] [Accepted: 11/05/2021] [Indexed: 10/19/2022]
Abstract
Here, we report a case of necrotizing fasciitis following intra-articular injection of hyaluronic acid. A 73-year-old female received intra-articular injections of hyaluronic acid due to arthralgia at the left shoulder and knee, and was found dead in her living room at one day. At the forensic autopsy, injection marks with bullae and erythema were found at the left shoulder and knee and liquefactive necrosis of muscle tissues was observed in the left but not right extremities. Histopathological examinations of the left upper arm and thigh revealed severe rhabdomyolysis with lots of bacterial clusters. Bacteriological examinations detected group A Streptococcus from intracardiac blood and affected muscle tissues. Postmortem biochemical analysis of blood showed escalated blood urea nitrogen (133.8 mg/dL), creatinine (4.57 mg/dL) and C-reactive protein (45.0 mg/dL). The cause of her death was diagnosed as streptococcal toxic shock syndrome (STSS). Moreover, it was suggested that the injection was inappropriately conducted and served as a portal of bacterial entry.
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Affiliation(s)
- Jumpei Matsuki
- Department of Forensic Medicine, Wakayama Medical University, 811-1 Kimiidera, 641-8509 Wakayama, Japan
| | - Akiko Ishigami
- Department of Forensic Medicine, Wakayama Medical University, 811-1 Kimiidera, 641-8509 Wakayama, Japan
| | - Motonari Tanaka
- Department of Forensic Medicine, Wakayama Medical University, 811-1 Kimiidera, 641-8509 Wakayama, Japan
| | - Satoshi Hata
- Department of Forensic Medicine, Wakayama Medical University, 811-1 Kimiidera, 641-8509 Wakayama, Japan
| | - Yuko Ishida
- Department of Forensic Medicine, Wakayama Medical University, 811-1 Kimiidera, 641-8509 Wakayama, Japan
| | - Mizuho Nosaka
- Department of Forensic Medicine, Wakayama Medical University, 811-1 Kimiidera, 641-8509 Wakayama, Japan
| | - Yumi Kuninaka
- Department of Forensic Medicine, Wakayama Medical University, 811-1 Kimiidera, 641-8509 Wakayama, Japan
| | - Hiroki Yamamoto
- Department of Forensic Medicine, Wakayama Medical University, 811-1 Kimiidera, 641-8509 Wakayama, Japan
| | - Emi Shimada
- Department of Forensic Medicine, Wakayama Medical University, 811-1 Kimiidera, 641-8509 Wakayama, Japan
| | - Yumiko Hashizume
- Department of Forensic Medicine, Wakayama Medical University, 811-1 Kimiidera, 641-8509 Wakayama, Japan
| | - Tatsunori Takayasu
- Department of Forensic Medicine, Wakayama Medical University, 811-1 Kimiidera, 641-8509 Wakayama, Japan
| | - Akihiko Kimura
- Department of Forensic Medicine, Wakayama Medical University, 811-1 Kimiidera, 641-8509 Wakayama, Japan
| | - Fukumi Furukawa
- Department of Forensic Medicine, Wakayama Medical University, 811-1 Kimiidera, 641-8509 Wakayama, Japan
| | - Toshikazu Kondo
- Department of Forensic Medicine, Wakayama Medical University, 811-1 Kimiidera, 641-8509 Wakayama, Japan.
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Detanac D, Mujdragic M, Detanac DA, Zogic E, Ceranic L, Alihodzic K, Mulic M, Mujdragic H. Necrotizing Soft Tissue Infection: A Single-Center Retrospective Study of Treatment and Outcomes. Cureus 2021; 13:e15039. [PMID: 34150390 PMCID: PMC8202215 DOI: 10.7759/cureus.15039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Introduction Necrotizing fasciitis is a severe inflammatory disease of the body's soft tissue characterized by spreading rapidly and high mortality. Rapid surgical intervention along with other supportive measures of treatment have a great impact on the outcome of treatment. Material and methods This study was conducted by a retrospective medical record review of all patients with a microbiologically and clinically confirmed diagnosis of necrotizing fasciitis who were admitted to the general surgery department at the General Hospital Novi Pazar, Serbia, during the period between 2017 and 2020. Demographic, clinical, laboratory, and microbiology data were analyzed. Results A total of 13 cases were identified, which represents 0.21% of the total number of patients treated at the surgical department during the period January 2017 to November 2020. The mean age of patients was 55 years, with a male/female ratio of 1:1.6. All of them had at least one comorbidity and more than half had three or more. Diabetes, cardiovascular diseases, and obesity were the most common comorbidities. The most common causes of infection were Klebsiella spp, Pseudomonas aeruginosa, S. pyogenes, and S. aureus. All patients received multiple surgical interventions (mean 2.3). Conclusion Treating necrotizing fasciitis requires a multidisciplinary approach. Early diagnosis and rapid clinical response allow for better disease outcomes. Getting to know more about necrotizing fasciitis will help doctors make better decisions when treating it.
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Affiliation(s)
- Dzemail Detanac
- Department of Surgery, General Hospital Novi Pazar, Novi Pazar, SRB
| | - Mehmed Mujdragic
- Department of Surgery, General Hospital Novi Pazar, Novi Pazar, SRB
| | - Dzenana A Detanac
- Department of Ophthalmology, General Hospital Novi Pazar, Novi Pazar, SRB
| | - Enes Zogic
- Department of Surgery, General Hospital Novi Pazar, Novi Pazar, SRB
| | - Lejla Ceranic
- Department of Infectious Diseases, General Hospital Novi Pazar, Novi Pazar, SRB
| | - Kemal Alihodzic
- Department of Surgery, General Hospital Novi Pazar, Novi Pazar, SRB
| | - Mersudin Mulic
- Department of Biomedical Science, State University of Novi Pazar, Novi Pazar, SRB
| | - Hana Mujdragic
- Department of Anaesthesiology, General Hospital Novi Pazar, Novi Pazar, SRB
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