INTRODUCTION
Necrotizing fasciitis is a life-threatening soft tissue infection
characterized by a rapidly spreading infection of the subcutaneous
tissue and in particular of the fascia that is accompanied by
significant systemic toxicity and high mortality1.
Management of infected tissues require rapid diagnosis, immediate
aggressive surgical management and prolonged debridement. In some cases,
early amputations of affected tissues and maximum intensive care
treatment are required, in case of sepsis.
The US Centers for Disease Control and Prevention estimates the
incidence of necrotizing fasciitis are up to 500-1,000 cases per year in
the United States, with an annual incidence rate of 0.4 cases per
100,000 population, while in most Occidental European countries is
around one case per 100,000 inhabitants. This incidence has increased
significantly in recent years, probably in relation to population aging
and the presence of a greater number of immunosuppressed subjects.
It is more common in men, going from 50 to 60% of cases, the average
age is 40 to 60 and the main affected site is the extremities.
Diagnosis is essentially clinical and in highly suspicious cases,
surgical exploration should not be delayed, since its prognosis largely
depends on early diagnosis and immediate aggressive treatment. Despite
the better knowledge of its etiopathogenesis and the availability of
more efficient therapeutic tools, its mortality has hardly changed in
recent years, exceeding 25%. Treatment is based on hemodynamic support,
early and extensive surgical treatment, and empirical antibiotic
therapy2-3.