Five cases of necrotizing fasciitis: Lack of skin inflammatory signs as a clinical clue for the fulminant type

Yohei Iwata, Shinichi Sato, Yumi Murase, Ayuko Iijima, Kaori Hayashi, Sakae Murakami, Toshikazu Usuda

Research output: Contribution to journalArticlepeer-review

6 Citations (Scopus)

Abstract

Herein, we describe five patients with necrotizing fasciitis (NF) who had variable outcomes and clinical manifestations. At the onset, all patients exhibited purpura with or without blister and ulceration accompanied by severe pain and tenderness in the affected skin. Out of five patients, three lacked inflammatory signs such as redness and heat, and two of the three patients showed fulminant progression and died despite intensive treatments including surgical debridement, antimicrobial therapy, close monitoring and physiological support. Tissue specimens from the patients without skin inflammatory signs showed mild neutrophil infiltration in addition to necrosis from the epidermis to subcutaneous fat, and variable amounts of thrombi. Furthermore, numerous bacteria were detected by Gram stain. By contrast, the remaining two patients with skin inflammatory signs revealed slower progression, and tissue specimens from both patients showed heavy neutrophil infiltration, but bacteria were hardly detected. Therefore, these cases suggest the possibility that the paucity of skin inflammatory signs, such as redness and heat, in NF may be a clinical clue to predict the fulminant type.

Original languageEnglish
Pages (from-to)719-725
Number of pages7
JournalJournal of Dermatology
Volume35
Issue number11
DOIs
Publication statusPublished - 11-2008
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Dermatology

Fingerprint Dive into the research topics of 'Five cases of necrotizing fasciitis: Lack of skin inflammatory signs as a clinical clue for the fulminant type'. Together they form a unique fingerprint.

Cite this