Necrotizing soft tissue infections

Background

• Includes necrotizing forms of cellulitis, myositis, and fasciitis

General types

• Type 1: polymicrobial infection
• Type 2: group A strep
  • May occur in healthy individuals
  • May occur via hematogenous spread from throat to site of blunt trauma

Specific Types

• Necrotizing Fasciitis
• Necrotizing Myositis
• Necrotizing Cellulitis

Differential Diagnosis

Skin and Soft Tissue Infection

• Cellulitis
  • Hand cellulitis
  • Facial cellulitis
• Erysipelas
• Lymphangitis
• Abscess
  • Bartholin gland abscess
• Necrotizing soft tissue infections
  • Necrotizing fasciitis
  • Necrotizing myositis
  • Necrotizing cellulitis
• Mycobacterium marinum

Look-A-Likes

• Sporotrichosis
• Osteomyelitis
• Deep venous thrombosis
• Pyomyositis

Necrotizing rashes

• Necrotizing soft tissue infections
  • Necrotizing fasciitis
  • Necrotizing myositis
  • Necrotizing cellulitis
• Purpura fulminans
• Drug rash
• Levamisole toxicity
  • Heparin-induced skin necrosis
  • Warfarin-induced skin necrosis

External Links

• MDCalc - LRINEC Score

References

• UpToDate

Authors

Ross Donaldson, Neil Young