Necrotizing Fasciitis
=================
What
is Necrotizing Fasciitis
and why would we have it on a website for
lymphedema?
The
most common name that it is
known by is "flesh eating bacteria." It is an infection that
is
becoming more common and as one of our members know all too well can
lead to a
secondary case of lymphedema. Another member who has
hereditary lymphedema
also experienced this horrible infection and almost lost her leg and
life.
Diagnosed
as a soft tissue
infection, this has been on the rise for several reasons.
These include
increased cases of diabetes,
cancer,
vascular
insufficiencies, organ
transplants, HIV and or leukopenia./neutropenia
which are themselves side
affects of many conditions including cancer.
Because
our lymphedema arms and
legs are
immunocompromised and because we are already so terribly
susceptible to
infections, we need to be aware of this very dangerous and potentially
life
threatening infection.
Related
keywords:
Fournier's
gangrene, Fournier
gangrene, Meleney's ulcer, Meleney ulcer, postoperative
progressive
bacterial synergistic gangrene,
flesh-eating
bacteria, Cullen's ulcer, Cullen ulcer, hemolytic
streptococcal gangrene,
acute dermal gangrene, hospital gangrene, suppurative
fascitis, synergistic necrotizing cellulitis, group
A hemolytic streptococci, Staphylococcus
aureus, Bacteroides
fragilis, Escherichia
coli, nonclostridial myonecrosis, Vibrio
vulnificus, diabetes
mellitus, fascial necrosis. (1)
Causes:
Necrotizing fasciitis is caused by several kinds of
bacteria. The most common cause is infection by a group A streptococcal
(GAS) bacterium, most often Streptococcus pyogenes,
which also causes other infections such as strep
throat and impetigo.
Usually the infections caused by these bacteria are mild. But in rare
cases the bacteria produce poisons (toxins) that can damage the soft
tissue below the skin and cause a more dangerous infection that can
spread quickly along the tissue covering the muscle (fascia). The
bacteria also can travel through the blood to the lungs and other
organs. The disease also may be caused by Vibrio vulnificus.
Infection with this bacterium can occur if wounds are exposed to ocean
water or contact raw saltwater fish or oysters. Infection also may
occur through injuries from handling sea animals such as crabs. These
infections are more common in people who have chronic liver diseases
such as cirrhosis.
Another type
of necrotizing fasciitis may be caused by multiple bacteria found in
the intestine. This type most often affects people with diabetes or peripheral
arterial disease. Sometimes people who have gunshot injuries,
intestinal surgery, or tumors in the lower digestive tract develop
necrotizing fasciitis.
A break in the
skin allows bacteria to infect the soft tissue. In some cases,
infection can also occur at the site of a muscle strain or bruise, even
if there is no break in the skin. It may not be obvious where the
infection started, because the bacteria may travel through the
bloodstream to other parts of the body.
Group A strep
bacteria producing the toxins that cause necrotizing fasciitis can be
passed from person to person. But a person who gets infected by the
bacteria is unlikely to develop a severe infection unless he or she has
an open wound, chickenpox, or an impaired
immune system. (1)
Diagnoses:
IInitial
suspected diagnosees can be
achieved by general examination, specifically how the skin and tissues
look, in
conjunction with other related symptoms. Diagnoses can be
achieved/confirmed
through the blood cultures, pus cultures and/or surgical
exploration.
Also, these tests will show the specific pathogen repsonsible.
X-rays may be needed to look for signs of lung damage or for gas or fluid buildup at the site of the infection.
Symptoms:
- Fever
- Moderate
to severe pain or tenderness, especially with no apparent injury or
wound
- Swelling
- Red
or dusky blue rash, especially if spreading quickly after the swelling
starts
- Flu-like
symptoms such as
Treatment:
Treatment
would include use of
strong broad based antibiotics given through an IV. Sugery or
debridement
might also be necessary.
The best treatment info I found was in through Medscape in their article Necrotizing Fascitis: "Treatment, "The most effective treatment found to decrease mortality is early diagnosis and prompt surgical debridement.The
gold standard of treatment for NF includes intravenous antibiotics with
broad-spectrum antibacterial coverage, prompt surgical debridement, and
supportive care in an intensive care unit (ICU). ICU care involving
hemodynamic support, wound care, and nutritional support is critical. A
combination of broad spectrum antibiotics, such as a penicillin, an
aminoglycoside or third generation cephalosporin, and clindamycin or
metronidazole, are typically employed to provide broad bacterial
coverage. Once the gram stain and culture and sensitivity results are
obtained, the antibiotic regimen can be adjusted."
Potential
Complications:
- Local
spread of infection, progressive tissue damage
- Systemic
spread of infection, sepsis,
shock
- Scarring
and disfigurement
- Functional
loss of an arm or leg
- Amputation
of limb
- Death
Prevention:
- See a healthcare provider to
check for strep if you have a sore throat with fever.
- People with strep throat should
stay home and away from others until they have completed the first 24
hours of antibiotic treatment.
- Use good hand washing when
someone has strep throat or other strep infection.
- Thoroughly clean skin injuries,
even minor cuts and scrapes, with soap and water and keep the wound
clean.
- If you have new or increasing
redness, swelling, wound drainage.
Be
respectful to protect others from infection if you suspect that you may
have a Strep infection, such as Strep throat, or have been exposed to
someone with a known Strep infection. Symptoms do not have to be
present for a person to be carrying the bacteria and infect others. One
case of infection that comes to mind is a health care worker with two
children at home with Strep throat. She had no symptoms, but innocently
infected three people, one of whom died.
The
most common causes of necrotizing
fasciitis are the group A hemolytic step bacteria or the staph aureus
bacteria. However, there are several other pathogens that can
cause
it. These include Bacteroides, Clostridium,
Peptostreptococcus,
Enterobacteriaceae, coliforms, Proteus, Pseudomonas,
and
Klebsiella.
Prognosis:
"The
prognosis for patients with necrotizing fasciitis depends on many
factors, including patient age, underlying medical problems, the
causative organism(s), extent and location of infection, as well as the
time course of diagnosis and initiation of treatment. Early diagnosis
and aggressive surgical and medical treatment are the most important
factors in determining outcome.
The
prognosis for patients with necrotizing fasciitis depends on many
factors, including patient age, underlying medical problems, the
causative organism(s), extent and location of infection, as well as the
time course of diagnosis and initiation of treatment. Early diagnosis
and aggressive surgical and medical treatment are the most important
factors in determining outcome.
Necrotizing
fasciitis is a life- and limb-threatening condition that carries a poor
prognosis if left untreated. Sequelae may include limb loss, scarring,
disfigurement and disability, with many patients going on to develop
sepsis, multisystem organ failure, and death. Combined morbidity and
mortality rates have been reported to be between 70%-80%. Mortality
rates may range anywhere between 6%-76%." (eMedicinehealth)
Pat
O'Connor
June 5,
2008
Since
our last update, I was in a hospital where one of the patients had
necrotizing fascitis. Through the course of the diseases, she lost both
hands, and half of both arms to this. I can no emphasis enough,
how imperative it is for those of us with lymphedema to get urgent
prompt treatment.
Jan. 12, 2012
....................................................
Necrotizing
soft tissue
infection
Alternative
names
Necrotizing fasciitis;
Fasciitis - necrotizing; Flesh-eating bacteria; Soft tissue gangrene;
Gangrene -
soft-tissue
Definition
Necrotizing
soft-tissue infection is a
severe type of tissue infection that can involve the skin, subcutaneous
fat, the muscle sheath (fascia), and the muscle. It causes gangrenous
changes,
tissue death, systemic
disease, and frequently death.
Causes,
incidence, and risk factors
Necrotizing
subcutaneous infection or
fasciitis can be caused by a variety of bacteria including oxygen-using
bacteria
(aerobic)
or oxygen-avoiding bacteria (anaerobic).
A very severe and usually fatal fasciitis is caused by a virulent
species of
streptococcus that is often referred to as the "flesh-eating bacteria"
by the press.
This type of infection develops when bacteria enter the body, usually
through a
minor skin injury or abrasion. The bacteria begin to grow and release toxins
that:
- Directly kill tissue
- Interfere with the blood
flow to the tissue
- Digest materials in the
tissue which then allows the bacteria to spread rapidly
- Cause widespread effects,
such as shock
Infection may begin as a small
reddish painful spot or
bump on the skin. This quickly changes to a painful bronzed or purplish
patch
that expands rapidly. The center may become black and dead (necrotic).
The skin may break open. Visible expansion of the infection may occur
in less
than an hour.
Symptoms may include fever,
sweating, chills, nausea,
dizziness, profound weakness, and finally shock. Without treatment
death can
occur rapidly.
Symptoms
- Severe pain in the area
- Swelling in the area
- Discoloration in the area
- May appear reddened,
bronzed, bruised, or purple (purpuric)
- Progresses to dusky,
dark color
- Bleeding into the skin
- Visibly dead (necrotic)
tissue
- Patchy skin color
- Skin breaks (open wound)
- Skin around the wound feels
hot and looks reddened, raised, or discolored (inflamed)
- Oozing fluid ranging from
yellowish clear or yellowish bloody to puslike in quality
- Fever
- General ill feeling
Signs and
tests
The appearance of the skin and
underlying tissues and
presence of gangrenous changes (black or dead tissue) indicates a
necrotizing
soft tissue infection. Imaging tests, such as CT scans, are sometimes
helpful.
Often a patient will need to
go to the operating room so a
surgeon can diagnose such an infection. A Gram stain and culture of
drainage or
tissue from the area may reveal the bacteria to blame.
Treatment
Powerful, broad-spectrum
antibiotics must be administered
immediately. They are given in a vein to attain high blood levels of
the
antibiotic in an attempt to control the infection. Surgery is required
to open
and drain infected areas and remove dead tissue.
Skin grafts may be required
after the infection is
cleared. If the infection is in a limb and cannot be contained or
controlled,
amputation of the limb may be considered. Sometimes pooled
immunoglobulins
(antibodies) are given by vein to help fight the infection.
If the organism is determined to be an oxygen-avoiding bacteria
(anaerobe) the
patient may be placed in a hyperbaric
oxygen chamber, a device in which the patient is exposed to 100% oxygen
at
several atmospheres of pressure.
Expectations
(prognosis)
Outcomes are variable. The
type of infecting organism,
rate of spread, susceptibility to antibiotics, and how early the
condition was
diagnosed all contribute to the final outcome.
Scarring and deformity are
common with this type of
disease. Fatalities are high even with aggressive treatment and
powerful
antibiotics. Untreated, the infection invariably spreads and causes
death.
Complications
- local spread of infection,
progressive tissue damage
- systemic
spread of infection, sepsis,
shock
- scarring and disfigurement
- functional loss of a limb
- death
Calling
your health care provider
This
disorder is severe and may be
life-threatening, so consult your health care provider immediately.
Call your health care provider if signs of infection occur around a
skin injury:
pain, swelling, redness, drainage of pus or blood, fever, or other
similar
symptoms.
Prevention
Clean
any skin injury thoroughly.
Watch for signs of infection such as redness, pain, drainage, swelling
around
the wound, and consult the health care provider promptly if these occur.
Update Date: 1/16/2004
http://www.nlm.nih.gov/medlineplus/ency/article/001443.htm
....................................................
What
is Necrotizing
fasciitis?
Necrotizing
fasciitis is a
severe bacterial infection. It is most commonly caused by Group A Strep
or a
mixture of bacteria including anærobic bacteria. Anærobic bacteria
thrive in
environments that are poor in oxygen, like wounds. Rarely, bacteria get
into the
thin membranes called fascia that connect the skin and underlying
muscle
tissues. In this environment, the bacteria destroy surrounding tissues
and can
spread rapidly through the body. Such an infection can quickly become
deadly.
Necrotizing
fasciitis
sometimes occurs in people who skin pop or muscle drugs and, more
rarely, among
intravenous users. The bacteria may come from contaminated dope, from
using
dirty injection equipment, or from bacteria on your skin. If the
bacteria are in
the drug itself, you can't depend on "cooking" to kill the bacteria.
This
type of infection has been
popularized in the press as "flesh-eating" bacteria. While cases are
rare in King County, over the past couple years doctors at Harborview
Medical
Center report treating one to two cases at any given time. Most local
cases
happen among injection drug users
How
to protect
yourself
You
can reduce your risk for
bacterial infections and abscesses.
- Use a brand new sterile syringe
every time you inject or divide drugs.
- Do not re-use syringes.
- Do not share syringes, cookers,
cottons, mixing or rinse water with anybody.
- If you must re-use injecting
equipment, clean it thoroughly with bleach. Click
here to learn more about "How to Bleach Your Works in 3 Easy
Steps."
- Before you inject, clean the
injection site with soap and hot water. Really scrub to remove harmful
bacteria that may be hanging out on your skin.
- If you can't use soap and hot
water, clean the site with alcohol wipes before you inject.
What
does Necrotizing fasciitis look and feel like?
- Typical signs of infection are
redness, swelling, warmth and tenderness.
- With necrotizing fasciitis,
skin around an injection site may show redness and swelling OR it may
look normal.
- The underlying area will feel
very tender.
- You may have pain, chills, and
fever.
- At the beginning, it may look
like a regular abscess, but it gets worse very quickly. It can cause
serious damage under your skin in as little as 12 hours.
Necrotizing fasciitis usually MOVES REALLY FAST.
- If you have these
signs of infection, or the redness or swelling around a wound gets
bigger, go to an EMERGENCY ROOM for treatment. Don't try to
treat this infection yourself. Bring a copy of
this webpage with you.
If
Necrotizing fasciitis
is caught early, it can be successfully treated. But it is very
important to
catch it early and begin treatment immediately.
This
infection is nothing to play
around with. If you do not get medical care early, you run the risk of
losing
skin, losing an arm, or even death.
Link no longer available
....................................................
Necrotizing
Fasciitis/Myositis
("flesh-eating disease")
Necrotizing
fasciitis (nek-roe-tie-zing
fah-shee-eye-tis)
is more commonly known as "flesh-eating disease". It is a rare illness
that causes extensive tissue destruction and can lead to death. In
Canada, there
are 90-200 cases of necrotizing fasciitis each year.
Definition
and Symptoms
Symptoms of necrotizing fasciitis include fever, severe pain, and a
red, painful
swelling which spreads rapidly. Death can occur in 12 to 24 hours. When
the
disease spreads along the layers of tissue that surround muscle (the
fascia), it
is called necrotizing fasciitis. When the
disease spreads into
the muscle tissue, it is called necrotizing myositis.
Cause
Necrotizing fasciitis can be caused by a number of different bacteria,
one of
them being the group A streptococcus. This is a common bacteria which
causes
infections, such as sore or strep throat, in children and young adults.
Ten to
15 per cent of school age children may carry group A streptococcus in
their
throat and have no symptoms. It is normally spread through close,
personal
contact with an infected person, for example, through kissing or
sharing
cutlery. This same bacteria also causes scarlet fever, impetigo and
rheumatic
fever.
Sometimes
group A streptococcus causes serious diseases such as pneumonia,
streptococcal toxic-shock syndrome, and necrotizing fasciitis and
myositis. In
instances where serious disease develops, the presence of sore throat
is very
unusual.
While group A
streptococcus is passed from person to person, necrotizing
fasciitis is not.
Background
The disease was first discovered in 1783, in France. Doctors noted that
it
occurred sporadically throughout the 19th and 20th centuries. The
disease was
usually restricted to military hospitals, especially in war times.
However,
there have been some outbreaks in civilian populations. The disease
appeared to
markedly decrease in frequency during the 1940s, and reemerged
worldwide in the
1980s.
In October
1998, serious group A streptococcal infections, such as
necrotizing fasciitis, were reportable to public health officials in
Newfoundland, Prince Edward Island, Quebec, Ontario, and Saskatchewan
only.
However, it was agreed that serious group A streptococcal infections
would be
under national surveillance from January 2000. In 1996, Health Canada's
Laboratory Centre for Disease Control studied serious group A
streptococcal
infections in nine Canadian health units across the country. These
health units,
called the Sentinel Health Unit Surveillance System (SHUSS), were used
to
periodically monitor rare diseases in selected populations.
The SHUSS
study and some provincial data showed that necrotizing fasciitis
from group A streptococcus occurred in roughly 3 to 7 persons per
1,000,000
population per year. The study also confirmed that, while rare,
necrotizing
fasciitis is fatal in approximately 20-30% of cases. The fatality rate
may be
higher if it occurs with the toxic shock syndrome.
Research
and Treatment
Treatment for necrotizing fasciitis usually involves surgically
removing
infected tissue - including amputation if necessary - and giving
antibiotics
such as penicillin and other drugs.
Researchers do
not know why the normally mild group A streptococcus bacteria
sometimes becomes a more serious threat. They are unsure exactly why
group A
streptococcus may cause minor infections, such as strep throat, in some
people,
and very serious infections, such as toxic shock syndrome or
necrotizing
fasciitis, in others. Bacteria have many different characteristics that
can
change over generations, keeping in mind that a generation for bacteria
can be
as short as 20 minutes.
An apparent
change in the level of disease activity (number of cases of
infection) can be due to changes in one or several of these bacterial
characteristics, a change in the type of person(s) exposed to the
bacteria or a
greater awareness of these infections. It is likely that all of these
possibilities have played a role in our perception of serious group A
streptococcal infections.
Many
scientists believe the bacteria makes proteins that cause the body's
immune system to destroy both the bacteria and body, in addition to
proteins
that destroy tissue directly.
There is no
vaccine available to prevent group A streptococcal infections.
Since there are many types of group A streptococci, one of the biggest
problems
facing researchers has been how to make one vaccine against all the
different
types.
Canadian
researchers are working on a new strategy that could help in the
treatment of flesh-eating disease.
What
Health Canada is Doing
Health Canada works with provincial and local public health officials
to monitor
infectious diseases. If requested, the Department will assist in the
investigation of clusters of these infectious diseases using our human
and
technical resources.
The
Department's Health Protection Branch through its Laboratory Centre for
Disease Control works with the National Streptococcus Centre in
Edmonton and
other public health officials to develop new strategies and treatments
to combat
these diseases.
http://www.phac-aspc.gc.ca/publicat/info/necro_e.html
....................................................
Necrotizing
Fasciitis
aka
Flesh-Eating Bacteria
The really scary thing about flesh-eating bacteria is that you've
already been
exposed to it.
Necrotizing
fasciitis is the name for a group of diseases which will
painfully liquefy all the meat on a victim's body, unless all affected
areas are
amputated.
The most
frequent cause of necrotizing fasciitis is Streptococcus A,
which you may know better as "strep throat," an extremely common
infection that almost everyone in America has suffered at one time or
another.
(There are other causes of necrotizing fasciitis, but they're even more
rare
than the already rare strep version).
The strep
bacteria is spread through direct contact, and occasionally through
coughing,
kissing , and other body contact. You can be a carrier of
strep without showing
any symptoms, but a 24-hour round of antibiotics is usually enough to
render a
victim non-contagious.
The most
common effect of a strep infection is a sore throat. The next-most
severe version of strep is called impetigo, a minor outbreak of skin
blisters.
According to the National Library of Medicine, impetigo "begins as an
itchy, red sore that blisters, oozes and finally becomes covered with a
tightly
adherent crust. It tends to grow and spread. ... The infection is
carried in the
fluid that oozes from the blisters."
Strep throat
almost never becomes necrotizing fasciitis, at least from a
statistical viewpoint (and you know what they say about statistics).
But when
your impetigo is impetigo-going-gone, you just might have a case of
streptococcal toxic shock syndrome (if you're lucky) or necrotizing
fasciitis
(if you're not).
STSS, the
disease which killed Muppets creator Jim
Henson, usually begins with a skin infection or an infected
wound.. Within
48 hours of infection, the victim's blood pressure drops dangerously
low, and
she may experience dizziness, fever, labored breathing, confusion,
rapid pulse
and peeling skin rash. You can die within two or three days, unless
treated with
antibiotics and amputation of affected areas.
But STSS is
still a step down from the king of all strep infections:
necrotizing fasciitis.
By now, you're
probably wondering, "How can I tell if I this annoying
rash is really necrotizing fasciitis?" The good news is that if you're
in
any kind of shape to ask the question, you probably don't have
necrotizing
fasciitis.
The first
thing to look for is when your itchy red sores quickly change into
yellow-purple swaths of flesh, which grow rapidly leaving a dead black
spot in
the center, while your pustulent and gangrenous skin excruciatingly
cracks open
and oozes various liquids, which might be yellow-clear, yellow-cloudy,
pus-like,
bloody, puslike-bloody, yellow-bloody, or bloody-yellow. Your skin may
become
cold and pale and bleed uncontrollably.
You may also
develop a fever or, as referenced in the list of official
symptoms, "a generalized feeling of discomfort ... accompanied by a
sensation of exhaustion or inadequate energy to accomplish usual
activities." Gee, ya think? As if all this wasn't bad enough, expect
diarrhea, vomiting, dehydration and kidney shutdown.
Fortunately,
all this pain and suffering won't last long! Left untreated,
necrotizing fasciitis will kill you in less than a week, sometimes much
less.
Treated incorrectly, it will take longer and be more painful. Treated correctly,
it will take what seems like forever, be excruciatingly painful and
leave you
permanently scarred. About 20% of those infected with necrotizing
fasciitis die
from the disease.
The good
news is necrotizing fasciitis is extremely rare. The bad news is that
there's no
way to prevent it. You can improve your odds slightly by becoming a
hygiene
freak and treating even the smallest scratches with antibiotic
ointment,
although if everyone did this, the bacteria would eventually evolve to
become
resistant to antibiotics, which would be much, much
worse for humanity.
But if you don't give a shit about humanity -- hey, go for it.
Unlike
leprosy, which was long believed to be highly contagious, necrotizing
fasciitis isn't a good reason to shun your neighbors or make them live
in
special colonies. (Actually, leprosy is no longer a good reason to do
that
either.) Necrotizing fasciitis isn't especially contagious, but it's
good sense
to wash out any open wounds on your skin after playing with your
necrotized
friends. Once the regimen of treatment is completed, there isn't any
further
risk of contagion.
No one knows
exactly how common necrotizing fasciitis might be, and it's
frequently misdiagnosed. Although reported cases have sharply increased
in
recent years, it's possible they were there all along. Currently, about
600
Americans per year are diagnosed with the disease, and it's believed
that Third
World countries have much higher rates of outbreak.
http://www.rotten.com/library/medicine/necrotizing-fasciitis/
....................................................
Necrotizing Fasciitis Caused by
Community-Associated Methicillin-Resistant Staphylococcus
aureus in Los Angeles
Loren G. Miller, M.D., M.P.H., Francoise
Perdreau-Remington, Ph.D., Gunter Rieg, M.D., Sheherbano Mehdi, M.D.,
Josh Perlroth, M.D., Arnold S. Bayer, M.D., Angela W. Tang, M.D., Tieu
O. Phung, M.D., and Brad Spellberg, M.D.
ABSTRACT
Background
Necrotizing fasciitis is a life-threatening infection requiring
urgent surgical and medical therapy. Staphylococcus
aureus has been a very uncommon cause of
necrotizing fasciitis, but we have recently
noted an alarming number of these infections caused
by community-associated methicillin-resistant S. aureus
(MRSA).
Methods
We reviewed the records of 843 patients whose wound cultures
grew MRSA at our center from January 15, 2003, to April 15,
2004. Among this cohort, 14 were identified as patients presenting
from the community with clinical and intraoperative findings
of necrotizing fasciitis, necrotizing myositis, or both.
Results
The median age of the patients was 46 years (range, 28
to 68), and 71 percent were men. Coexisting conditions or risk
factors included current or past injection-drug use (43 percent);
previous MRSA infection, diabetes, and chronic hepatitis C
(21 percent each); and cancer and human immunodeficiency virus
infection or the acquired immunodeficiency syndrome (7
percent each). Four patients (29 percent) had
no serious coexisting conditions or risk
factors. All patients received combined medical and
surgical therapy, and none died, but they had serious complications,
including the need for reconstructive surgery and prolonged
stay in the intensive care unit. Wound cultures were
monomicrobial for MRSA in 86 percent, and 40
percent of patients (4 of 10) for whom blood
cultures were obtained had positive results. All
MRSA isolates were susceptible in vitro to clindamycin, trimethoprim–sulfamethoxazole,
and rifampin. All recovered isolates belonged
to the same genotype (multilocus sequence type
ST8, pulsed-field type USA300, and staphylococcal cassette chromosome
mec type IV [SCCmecIV]) and
carried the Panton–Valentine leukocidin (pvl),
lukD, and lukE genes, but no
other toxin genes were detected.
Conclusions
Necrotizing fasciitis caused by community-associated MRSA
is an emerging clinical entity. In areas in which community-associated
MRSA infection is endemic, empirical treatment of suspected
necrotizing fasciitis should include antibiotics predictably
active against this pathogen.
Source
Information
From
the Divisions of Infectious Diseases and HIV Medicine (L.G.M., G.R.,
A.S.B., B.S.) and the Department of Internal Medicine (L.G.M., G.R.,
J.P., A.S.B., B.S.), Harbor–UCLA Medical Center and the Los Angeles
Biomedical Institute at Harbor–UCLA, Torrance; the University of
California, San Francisco (F.P.-R.); and St. Mary Medical Center, Long
Beach (S.M., A.W.T., T.O.P.) — all in California
http://content.nejm.org/cgi/content/short/352/14/1445?query=TOC
....................................................
External Links
--------
National Necrotizing
Fasciitis Foundation
http://www.nnff.org/
--------
The 'Lee Spark' NF
Foundation
NF Support in England/UK
http://www.nfsuk.org.uk/
--------
NECROTIZING
FASCIITIS:
A Survivor's Story by Doreen Mulman
http://doreen.mkbmemorial.com/NF/
--------
Overcoming
Necrotizing Fasciitis
http://www.flesheatingbacteria.net/
--------
Necrotizing
Fasciitis Clinical Resources
http://www.mdconsult.com/recommended-results/NECROTIZINGFASCIITIS.lp
--------
Necrotizing Fasciitis
eMedicine
http://www.emedicine.com/EMERG/topic332.htm
--------
Necrotizing
Fasciitis (Flesh-Eating Bacteria) (1)
http://my.webmd.com/hw/health_guide_atoz/hw140408.asp
--------

http://www.nnff.org/
--------
Google
Diagnostic Images
http://images.google.com/images?q=Necrotizing+Fasciitis&hl=en&lr=&ie=UTF-8&sa=N&tab=wi
Yahoo
http://images.search.yahoo.com/search/images;_ylt=At4xTxEaudlLn56QVFvJvFObvZx4?p=Necrotizing+Fasciitis&toggle=1&cop=mss&ei=UTF-8&fr=yfp-t-70
-------------------------------
External
Codes and Classifications:
ICD-10
| M72.6 |
|
Necrotizing fasciitis |
|
|
Use additional code, if
desired, to identify infectious agent |
ICD-9
2008 ICD-9-CM
Diagnosis 728.86
-
Necrotizing
fasciitis
- A
fulminating group A streptococcal infection beginning with severe or
extensive cellulitis that spreads to involve the superficial and deep
fascia, producing thrombosis of the subcutaneous vessels and gangrene
of the underlying tissues. A cutaneous lesion usually serves as a
portal of entry for the infection, but sometimes no such lesion is
found. (Dorland, 28th ed)
- 728.86
is a specific code that can be used to specify a diagnosis
- 728.86
contains 1 index entry
- View
the ICD-9-CM Volume 1 728.*
hierarchy
Use
additional code to identify:
- infectious
organism (041.00-041.89)
- gangrene
(785.4), if applicable
MedlinePlus
001443
MeSH
D019115
-------------------------------
Related
Lymphedema People Medical Blogs and Pages:
------------
Bacterial Infections
http://bacteriainfections.blogspot.com
Antibiotics
http://antibioticinformation.blogspot.com/
Cellulitis
http://cellulitisinfections.blogspot.com/
MRSA Information
http://mrsainformation.blogspot.com/
Antibiotic Glossary
http://www.lymphedemapeople.com/phpBB2/viewforum.php?f=34
Antibiotic Therapy, Types of Antibiotics
http://www.lymphedemapeople.com/thesite/lymphedema_antibiotics.htm
===========================
Join us
as we work for lymphedema patients everywhere:
Advocates
for Lymphedema
Dedicated to
be an advocacy group for lymphedema patients. Working towards
education, legal reform, changing insurance practices, promoting
research, reaching for a cure.
http://health.groups.yahoo.com/group/AdvocatesforLymphedema/
Pat O'Connor
Lymphedema People / Advocates for Lymphedema
===========================
For information about Lymphedema
http://www.lymphedemapeople.com/wiki/doku.php?id=lymphedema\
For Information about Lymphedema Complications
http://www.lymphedemapeople.com/wiki/doku.php?id=complications_of_lymphedema
For Lymphedema Personal Stories
http://www.lymphedemapeople.com/phpBB3/viewforum.php?f=3
For information about How to Treat a
Lymphedema Wound
http://www.lymphedemapeople.com/wiki/doku.php?id=how_to_treat_a_lymphedema_wound
For information about Lymphedema Treatment
http://www.lymphedemapeople.com/wiki/doku.php?id=treatment
For information about Exercises for
Lymphedema
http://www.lymphedemapeople.com/wiki/doku.php?id=exercises_for_lymphedema
For information on Infections Associated with
Lymphedema
http://www.lymphedemapeople.com/wiki/doku.php?id=infections_associated_with_lymphedema
For information on Lymphedema in Children
http://www.lymphedemapeople.com/wiki/doku.php?id=lymphedema_in_children
Lymphedema Glossary
http://www.lymphedemapeople.com/wiki/doku.php?id=glossary:listing
===========================
Lymphedema People - Support Groups
-----------------------------------------------
Children with Lymphedema
The time has come for families, parents, caregivers to have a support
group of their own. Support group for parents, families and caregivers
of chilren with lymphedema. Sharing information on coping, diagnosis,
treatment and prognosis. Sponsored by Lymphedema People.
http://health.groups.yahoo.com/group/childrenwithlymphedema/
Subscribe: childrenwithlymphedema-subscribe@yahoogroups.com
......................
Lipedema
Lipodema Lipoedema
No matter how you spell it, this is another very little understood and
totally frustrating conditions out there. This will be a support group
for those suffering with lipedema/lipodema. A place for information,
sharing experiences, exploring treatment options and coping.
Come join, be a part of the family!
http://health.groups.yahoo.com/group/lipedema_lipodema_lipoedema/?yguid=209645515
Subscribe: lipedema_lipodema_lipoedema-subscribe@yahoogroups.com
......................
MEN WITH
LYMPHEDEMA
If you are a man with lymphedema; a man with
a loved one with lymphedema who you are trying to help and understand
come join us and discover what it is to be the master instead of the
sufferer of lymphedema.
http://health.groups.yahoo.com/group/menwithlymphedema/
Subscribe: menwithlymphedema-subscribe@yahoogroups.com
......................
All About Lymphangiectasia
Support group for parents, patients, children who suffer from all forms
of lymphangiectasia. This condition is caused by dilation of the
lymphatics. It can affect the intestinal tract, lungs and other
critical body areas.
http://health.groups.yahoo.com/group/allaboutlymphangiectasia/
Subscribe: allaboutlymphangiectasia-subscribe@yahoogroups.com
......................
Lymphatic
Disorders Support Group @ Yahoo Groups
While we have a number of support groups for lymphedema... there is
nothing out there for other lymphatic disorders. Because we have one of
the most comprehensive information sites on all lymphatic disorders, I
thought perhaps, it is time that one be offered.
DISCRIPTION
Information and support for rare and unusual disorders affecting the
lymph system. Includes lymphangiomas, lymphatic malformations,
telangiectasia, hennekam's syndrome, distichiasis, Figueroa
syndrome, ptosis syndrome, plus many more. Extensive database of
information available through sister site Lymphedema People.
http://health.groups.yahoo.com/group/lymphaticdisorders/
Subscribe: lymphaticdisorders-subscribe@yahoogroups.com
===========================
Lymphedema
People New Wiki Pages
Have
you seen our new “Wiki” pages yet?
Listed below are just a sample of the more than 140 pages
now listed in our Wiki section. We are also working on hundred more. Come and take a
stroll!
Lymphedema Glossary
http://www.lymphedemapeople.com/wiki/doku.php?id=glossary:listing
Lymphedema
http://www.lymphedemapeople.com/wiki/doku.php?id=lymphedema
Arm
Lymphedema
http://www.lymphedemapeople.com/wiki/doku.php?id=arm_lymphedema
Leg
Lymphedema
http://www.lymphedemapeople.com/wiki/doku.php?id=leg_lymphedema
Acute
Lymphedema
http://www.lymphedemapeople.com/wiki/doku.php?id=acute_lymphedema
The
Lymphedema Diet
http://www.lymphedemapeople.com/wiki/doku.php?id=the_lymphedema_diet
Exercises
for Lymphedema
http://www.lymphedemapeople.com/wiki/doku.php?id=exercises_for_lymphedema
Diuretics
are not for Lymphedema
http://www.lymphedemapeople.com/wiki/doku.php?id=diuretics_are_not_for_lymphedema
Lymphedema
People Online Support Groups
http://www.lymphedemapeople.com/wiki/doku.php?id=lymphedema_people_online_support_groups
Lipedema
http://www.lymphedemapeople.com/wiki/doku.php?id=lipedema
Treatment
http://www.lymphedemapeople.com/wiki/doku.php?id=treatment
Lymphedema
and Pain Management
http://www.lymphedemapeople.com/wiki/doku.php?id=lymphedema_and_pain_management
Manual Lymphatic
Drainage (MLD) and Complex Decongestive Therapy (CDT)
http://www.lymphedemapeople.com/wiki/doku.php?id=manual_lymphatic_drainage_mld_complex_decongestive_therapy_cdt
Infections
Associated with Lymphedema
http://www.lymphedemapeople.com/wiki/doku.php?id=infections_associated_with_lymphedema
How
to Treat a Lymphedema Wound
http://www.lymphedemapeople.com/wiki/doku.php?id=how_to_treat_a_lymphedema_wound
Fungal
Infections Associated with Lymphedema
http://www.lymphedemapeople.com/wiki/doku.php?id=fungal_infections_associated_with_lymphedema
Lymphedema
in Children
http://www.lymphedemapeople.com/wiki/doku.php?id=lymphedema_in_children
Lymphoscintigraphy
http://www.lymphedemapeople.com/wiki/doku.php?id=lymphoscintigraphy
Magnetic
Resonance Imaging
http://www.lymphedemapeople.com/wiki/doku.php?id=magnetic_resonance_imaging
Extraperitoneal
para-aortic lymph node dissection (EPLND)
http://www.lymphedemapeople.com/wiki/doku.php?id=extraperitoneal_para-aortic_lymph_node_dissection_eplnd
Axillary node biopsy
http://www.lymphedemapeople.com/wiki/doku.php?id=axillary_node_biopsy
Sentinel
Node Biopsy
http://www.lymphedemapeople.com/wiki/doku.php?id=sentinel_node_biopsy
Small Needle Biopsy -
Fine Needle Aspiration
http://www.lymphedemapeople.com/wiki/doku.php?id=small_needle_biopsy
Magnetic Resonance
Imaging
http://www.lymphedemapeople.com/wiki/doku.php?id=magnetic_resonance_imaging
Lymphedema Gene FOXC2
http://www.lymphedemapeople.com/wiki/doku.php?id=lymphedema_gene_foxc2
Lymphedema Gene VEGFC
http://www.lymphedemapeople.com/wiki/doku.php?id=lymphedema_gene_vegfc
Lymphedema Gene SOX18
http://www.lymphedemapeople.com/wiki/doku.php?id=lymphedema_gene_sox18
Lymphedema
and Pregnancy
http://www.lymphedemapeople.com/wiki/doku.php?id=lymphedema_and_pregnancy
Home page: Lymphedema People
http://www.lymphedemapeople.com
Jan. 16, 2012