Surveying necrotizing fasciitis in a teaching

Necrotizing fasciitis is an uncommon severe infection involving the subcutaneous soft tissue, particularly the superficial and often the deep fascia. Early diagnosis is of utmost importance since the disease progress rapidly. The present study was conducted to determine clinical, laboratory and therapeutic aspects of necrotizing fasciitis in a group of Iranian patients referred to a referral center in Tehran between 1999 and 2003. For this descriptive study, all patients with the diagnosis of necrotizing fasciitis referred to Imam Khomeini hospital during a 4-year period (1999-2003) were enrolled. The diagnosis of necrotizing fasciitis was verified according to the clinical, radiologic, and direct inspection of a surgeon. Totally, 34 patients referred during the studied period with the mean age of 43.7±28.3 years and male to female ratio of 19:15. Tachycardia (41.2%) and tachypenia (44.1%) were the most common presenting signs. Lower limb was the most frequent site of involvement (70.5%). Totally, 64 operations were performed (2.14 operation/ patient). Necrotizing fasciitis should be ruled out in any patient presented with pain, flu-like symptoms, swelling, blisters, and necrotizing appearance skin, especially if it is associated with diabetes mellitus, injecting drug abuse or recent trauma. Prompt diagnosis, suitable antibiotic use, and extensive operation could significantly reduce mortality.