Necrotizing fasciitis: Definition
Definition: Flesh Eating Bacteria
Fasciitis is the inflammation of a fascia or fascia (tissue that surrounds the muscles and organs) due to infection itself following the penetration of microbes in these tissues.
Necrotizing fasciitis (which destroys tissue) was formerly called streptococcal gangrene (infection by group A streptococcus). It may also be within the scope of gas gangrene after penetration of a seed, Clostridium perfringens.
Necrotizing Fasciitis: Causes
The origins of necrotizing fasciitis is multiple. It may be (the list is not exhaustive):
- A trivial wound
- Scratch slightly deeper than usual
- A hemorrhoid
- Diverticulum (cavity communicating with a hollow organ, mainly the digestive tract)
- An anal fissure
- Rupture of the urethra (urinary canal that carries urine from the bladder to the outside)
- Some diseases facilitate the occurrence of necrotizing fasciitis as diabetes
- A disease affecting the blood vessels (angiopathy)
- Surgery
- Injury following the penetration of an object in the abdomen
Necrotizing fasciitis: Classification
There is a special case called necrotizing fasciitis Fournier's gangrene is characterized by a swelling of the scrotum (skin envelope of the testicles). It exists a form of necrotizing fasciitis secondary to pyogenic staph germ called and whose frequency has increased in severity since the 80s. The proliferation of these organisms always causes gas production causing renal failure (inadequate renal function) in about 30% of cases. Myositis (muscle inflammation) accompanied by pain and progressive destruction of muscles, occurs in most cases. Creatine phosphokinase (original muscle enzyme) is usually increased. Surgical excision fast approaching the deep fascia and muscles is an easy gesture, which must be accompanied by a tissue ablation dead. The medical journal New England Journal of Medicine (2000) describes in his column: In Florida, a necrotizing fasciitis was caused by laceration of the right leg by a variety of lines called pastenague. L sting carried by the tail of the animal caused a wound which resulted necrotizing fasciitis requiring the type of treatment described above. The causative agent is a damsel Photo bacterium, Vibrio formerly damsel. After leaving the hospital, the patient will need a skin graft. (The stingray is a line which has a sting that dangerous. It does not exist only in Florida is also found on the French coast. This animal is between 2m and 2m 50 and weighs between 180 and 220 kilos).
Necrotizing Fasciitis: Symptoms
The diagnosis is sometimes difficult. Initially, the patient complains of:
- Pain
- Unexplained fever
- Swelling
- Hard and slightly painful swelling
- Dark red color and elevation of the epidermis
Necrotizing fasciitis: Evolution of the disease.
Quickly, we are witnessing the formation of bubbles filled with a blue liquid purplish. Subsequently, the skin becomes fragile and takes a bluish color, then brown or black. In a second time, the infection is likely to reach the deep fascia (fibrous membranes that envelop the muscles separated from each other). She eventually gives color to dark-gray skin of the affected part. At this advanced stage, patients show signs of toxic shock that reflect a lack of operating several organs. The shock, also known as sepsis, is widespread inflammation throughout the body and results in a loss of all viscera which can no longer their role properly.
Necrotizing fasciitis: Complications of the disease
Gas gangrene, which is an advanced stage in the development of necrotizing fasciitis, resulting in necrosis (death) of tissues, most commonly due to a lesion of the skin or mucous membranes due to an accident surgery. It is also favored by the occurrence of hematoma or penetration of a foreign body through the wound (land most often). The multiplication of germs that causes smelly gas diffuses through the skin, and palpation constitutes what is called crepitus (gas refers to the noise made by a person walking in the snow). Gas gangrene causes a weakening in the patient with a significant drop in blood pressure and other signs of local or general rapidly evolving. The pain is intense, high fever. Fortunately, this disease, is almost currently observed. Nevertheless, it still affects diabetics who are particularly sensitive to any form of infection.
Necrotizing Fasciitis: Treatment
Treatment of necrotizing fasciitis comprises: A cleaning wound debridement of skin and muscle fascia (large incision in the infected area) A sample and culturing the bacteria are carried out in parallel. The administration association's intravenous antibiotics (Doxycycline, Cefazolin, Tobramycin) Gas gangrene requires treatment with oxygen (hyperbaric oxygen administration: high pressure) and removal of necrotic (dead). The prognosis is still very reserved.
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