Back
 IJCM  Vol.2 No.2 , May 2011
Necrotizing Fasciitis of the Upper and Lower Limbs: Port Harcourt Experience
Rollings Jamabo, Solomon Elenwo
Abstract: Background: Necrotizing fasciitis (NF) is a rare but life-threatening soft-tissue infection characterized by rapidly spreading inflammation and subsequent necrosis of the fascial planes and surrounding tissue. Aim: To determine the clinical characteristics at presentation, causative pathogens and clinical outcome of NF after aggressive management. Patients and methods: We retrospectively reviewed case notes of patients with NF referred to the Teaching Hospital in Port Harcourt from January 2004 to December 2009. Results: The case notes of over 2,280 patients with history of cellulitis and/or infections of the upper and lower limbs were reviewed. These cases were seen in a five-year period from 2004 to 2009. Seventy five (3.29%) patients had a diagnosis of necrotizing fasciitis and were evaluated. Only those with infections on the lower and upper limbs were further analyzed. Thirty five (46.67%) patients had their infections in the lower limb while 40 (53.33%) patients had their infections in the upper limb. Twenty (26.67%) patients were found to be diabetic on admission. Thirty (30%) patients sustained injuries on their limbs while 5 (6.67%) patients could not give account of their infections. Eleven (14.66%) patients had fixed flexion deformities as their wounds healed and had to have further plastic surgery to extend their limbs and 7 (9.33%) patients died while on admission. Conclusion: Although an early diagnosis of NF can be difficult, a high index of suspicion is required in all patients presenting with unexplained warmth and/or cellulitis of the limbs, so that prompt and aggressive debridement can be carried out with commencement of broad spectrum antibiotics.
Keywords: Necrotizing fasciitis, Causative Organisms, Treatment Outcome
Cite this paper: nullR. Jamabo and S. Elenwo, "Necrotizing Fasciitis of the Upper and Lower Limbs: Port Harcourt Experience," International Journal of Clinical Medicine, Vol. 2 No. 2, 2011, pp. 86-88. doi: 10.4236/ijcm.2011.22017.
References

[1]   [1] D. Huljev and N. Kucisec-Tepes, “Necrotizing Fasciitis of the Abdominal Wall as a Post-Surgical Complication: A Case Report,” Wounds, Vol. 17, No. 7, 2005, pp. 169-177.

[2]   [2] J. N. Legbo and J. F. Legbo, “Bacterial Isolates From Ne- crotizing Fasciitis: A Clinico-Pathological Perspective,” Nigerian Journal of Medicine, Vol. 16, No. 2, 2007, pp. 143-147.

[3]   [3] R. J. Green, D. C. Dafoe and T. A. Raffin, “Necrotizing Fasciitis,” Chest, Vol. 110, No. 1, 1996, pp. 219-229. doi:10.1378/chest.110.1.219

[4]   [4] R. Puvanendran, J. C. Huey and S. Pasupathy, “Ne- crotizing Fasciitis,” Canadian Family Physician, Vol. 55, No. 10, 2009, pp. 981-987.

[5]   [5] E. J. Whallett, J. H. Stevenson and A. D. Wilmshurst, “Necrotizing Fasciitis of the Extremity,” Journal of Plastic, Reconstructive & Aesthetic Surger, Vol. 63, No. 5, 2010, pp. 469-473. doi:10.1016/j.bjps.2009.09.011

[6]   [6] S. D. Fritzsche, “Soft Tissue Infection: Necrotizing Fa- sciitis,” Plastic Surgery Nursing, Vol. 23, No. 4, 2003, pp. 155-159.

[7]   [7] M. Nisbet, G. Ansell, S. Lang, S. Taylor, P. Dzen- drowskyj and D. Holland, “Necrotizing Fasciitis: Review of 82 Cases in South Auckland,” Journal of Clinical Endocrinology & Metabolism, Vol. 95, No. 1, 2010, pp. 11-12.

[8]   [8] A. Rajput, Waseem, A. Samad, T. W. Khanazada, G. M. Shaikh and G. A. Channa, “Mortality in Necrotizing Fasciitis,” Journal of Ayub Medical College Abbottabad, Vol. 20, No. 2, 2008, pp. 96-98.

[9]   [9] C. H. Wong and Y. S. Wang, “The Diagnosis of Necrotizing Fasciitis,” Current Opinion in Infectious Diseases, Vol. 18, No. 2, 2005, pp. 101-106. doi:10.1097/01.qco.0000160896.74492.ea

[10]   [10] E. J. McGee, “Necrotizing Fasciitis: Review of Patho- physiology, Diagnosis and Treatment,” Critical Care Nursing Quarterly, Vol. 28, No. 1, 2005, pp. 80-84.

 
 
Top