Necrotizing fasciitis in Child
In the pediatric population, type 2 (monomicrobial) infections are much more common than type 1 (polymicrobial) infections.
Streptococcus species, particularly S pyogenes, and MRSA are equally found to be the most common causative organisms involved in the pediatric population, followed by Pseudomonas aeruginosa.
Necrotizing fasciitis can occur without a clear portal of entry, although predisposing risk factors in the pediatric population include blunt and penetrating trauma, general infectious conditions, and breaches in the skin and mucosa (eg, lacerations, varicella vesicles, penetrating wounds, dog or insect bites, chronic skin conditions, and surgical wounds).
Patients with necrotizing fasciitis are acutely ill. They are often thought to have cellulitis that is not responding to standard antibiotic therapy. There is commonly a paucity of cutaneous findings in the early course of the disease. Pain is out of proportion to physical findings, although this may not be present in the pediatric population. There may be associated skin necrosis and bullae formation. Signs of systemic illness such as fever, lethargy, hypotension, and tachycardia are present; these may progress to multiorgan failure.
The mortality of necrotizing fasciitis is high. Treatment includes broad-spectrum intravenous (IV) antibiotics and immediate surgical debridement of infected and devitalized tissue. Therefore, if you are considering this diagnosis, stop reading this and contact a surgeon now.
When necrotizing fasciitis is localized to the lower abdominal wall, perineum, or genitals, it is known as Fournier gangrene. Diabetic patients are particularly susceptible to Fournier gangrene, which is often polymicrobial with mixed anaerobic organisms.
M72.6 – Necrotizing fasciitis
52486002 – Necrotizing fasciitis
- Subcutaneous acute febrile neutrophilic dermatosis (subcutaneous Sweet syndrome)
- Ecthyma gangrenosum
- Deep vein thrombosis
- Purpura fulminans complicating varicella
- Insect bite (eg, brown recluse spider)
- Disseminated intravascular coagulation
- Staphylococcal scalded skin syndrome
- Toxic shock syndrome
- Vibrio vulnificus infection
Last Updated: 05/13/2019