Necrotizing Fasciitis ALTIN VESELI. What is Necrotizing Fasciitis? Hippocrates in the 15th century...
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Transcript of Necrotizing Fasciitis ALTIN VESELI. What is Necrotizing Fasciitis? Hippocrates in the 15th century...
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Necrotizing Fasciitis
ALTIN VESELI
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What is Necrotizing Fasciitis?
• Hippocrates in the 15th century BC, spoke of it as a complication of erysipelas.
• Flesh eating bacteria• Group A streptococcus(Streptococcus
pyogenes), Staphylococcus aureus, Clostridium perfringens.
• Type 1 (Polymicrobial),Type 2 (Monomicrobial)
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Erysipelas:Red Skin
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How does it work?
• Bacteria enter the body through a break in the skin
• Paper cuts, Scrape, Burn, Surgical wound. • Progresses very rapidly • Immunosuppressed individuals(diabetics,
elderly, liver disease, AIDS,chemotherapy)• Healthy, strong immune system, practice
good hygiene and proper wound care.
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Diagnosis
• The Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score
• It uses 6 serologic measures: C-reactive protein, total WBC count, hemoglobin, creatinine and glucose.
• <6 indicates that necrotizing fasciitis should seriously be considered.
• >6 Higher rate of mortality and amputation.
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Symptoms
• Similar and difficult to differentiate from cellulitis • Severe pain in the affected area. • Redness, Swelling, Hot skin • Fever, Chills, Fatigue may follow the initial
wound or soreness. • Skin discoloration(violet), blisters, discharge of
dish-water like fluid.
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Patient developed rapidly progressive painful erythema and edema following a bee sting. Necrotizing fasciitis was diagnosed.
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Patient in the healing process
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Treatment
• Early diagnosis=Early treatment• Intravenous antibiotic
therapy(piperacillin/tazobactam, vancomycin, and clindamycin)
• Intravenous immunoglobulin• Surgery(depridement) • Amputation of affected limb• Hyperbaric oxygen therapy
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Notable cases
• 2004: Eric Allin Cornell, winner of the 2001 Nobel Prize in Physics, lost his left arm and shoulder to the disease.
• 2012: Aimee Copeland, a 24-year-old graduate student, contracted necrotizing fasciitis after she fell from a zip-line into the Little Tallapoosa River which caused a deep cut in her leg. Copeland’s entire leg was amputated along with her other limbs as a side effect of the disease and treatment. Five of her organs also failed as a result of the ordeal.
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References
• https://en.wikipedia.org/wiki/Necrotizing_fasciitis
• http://www.cdc.gov/features/necrotizingfasciitis/
• http://www.medscape.com/viewarticle/444061_4
• http://www.medicinenet.com/necrotizing_fasciitis/page3.htm