dermatologic disorders
Necrotizing Soft Tissue Infection
Introduction
Necrotizing soft-tissue infection is typically caused by a mixture of aerobic and anaerobic organisms that cause necrosis of subcutaneous tissue, usually including the fascia. This infection most commonly affects the extremities and perineum. Affected tissues become erythematous, warm, and swollen, resembling severe cellulitis, and pain develops out of proportion to clinical findings. During surgical exploration, there is a gray exudate, friable superficial fascia, and absence of pus. Without timely treatment, the area becomes gangrenous. Patients are acutely ill. Diagnosis is by history and examination and is supported by evidence of overwhelming infection. Treatment involves antibiotics and surgical debridement. Prognosis is poor without early, aggressive treatment. (See also Overview of Bacterial Skin Infections .) 