Necrotizing cellulitis

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Background

  • Patients are often much less toxic compared with necrotizing fasciitis/necrotizing myositis
  • Two types:
    • Anaerobic infection (clostridial and nonclostridial)
    • Meleney's synergistic gangrene
      • Rare infection that occurs in postop patients
      • Characterized by slowly expanding indolent ulceration that is confined to superficial fascia
      • Results from synergistic interaction between S. aureus and microaerophilic streptococci

Risk Factors

  • Trauma
  • Surgical contamination
  • Spread of infection from bowel to perineum, abdominal wall, or lower extremities

Clinical Features

  • Thin, dark, sometimes foul-smelling wound drainage (often containing fat globules)
  • Tissue gas formation (crepitus)

Differential Diagnosis

Skin and Soft Tissue Infection

Look-A-Likes

Necrotizing rashes

Evaluation

Management

Disposition

  • Admit/OR

See Also

References