ABSTRACT
Necrotizing fasciitis is a severe infection, with systemic involvement and tissue necrosis. The clinical course is rapid and often fatal. Although this entity is uncommon, early recognition and treatment is essential to improve prognosis. Necrotizing fasciitis should be suspected when there are symptoms of toxicity and there is severe pain, frequently out of proportion to the clinical findings. In addition, in the last few years the incidence of invasive disease due to Streptococcus pyogenes in children has increased. Treatment is based on life support, aggressive debridement, and antimicrobial therapy. Intravenous immunoglobulin (IVIG) as adjunctive therapy seems useful and reduces mortality. The case of an infant with necrotizing fasciitis of four extremities is presented.
Subject(s)
Fasciitis, Necrotizing , Fasciitis, Necrotizing/diagnosis , Fasciitis, Necrotizing/therapy , Humans , Infant , MaleABSTRACT
La fascitis necrosante es una infección grave, con afectación sistémica y necrosis de tejidos, con un curso rápido y con frecuencia fatal. Aunque es una entidad poco frecuente, debe ser sospechada y tratada precozmente ya que mejora el pronóstico. Pensaremos en ella ante un cuadro tóxico con dolor desproporcionado a los hallazgos en la exploración. La incidencia de enfermedad invasiva por Streptococcus pyogenes en niños está en aumento en los últimos años. El tratamiento se basa en medidas de soporte, desbridamiento quirúrgico amplio y antibioterapia; la asociación de inmunoglobulina inespecífica intravenosa parece beneficiosa, reduciendo la mortalidad. Se presenta el caso de un lactante con fascitis necrosante de las cuatro extremidades
Necrotizing fasciitis is a severe infection, with systemic involvement and tissue necrosis. The clinical course is rapid and often fatal. Although this entity is uncommon, early recognition and treatment is essential to improve prognosis. Necrotizing fasciitis should be suspected when there are symptoms of toxicity and there is severe pain, frequently out of proportion to the clinical findings. In addition, in the last few years the incidence of invasive disease due to Streptococcus pyogenes in children has increased. Treatment is based on life support, aggressive debridement, and antimicrobial therapy. Intravenous immunoglobulin (IVIG) as adjunctive therapy seems useful and reduces mortality. The case of an infant with necrotizing fasciitis of four extremities is presented
