Types
Defining Characteristics
Initially presents with cellulitis, blood-filled bullae,
ecchymosis, systemic toxicity, elevated CPK
RED FLAGS: severe pain out of proportion w/ skin findings, large bullae, skin necrosis/ecchymosis, wooden hard feel of subq tissue, numbness of skin, systemic toxicity, rapid spread w/ AB tx
Disease Development
Initial break in skin from trauma or surgery causes advancing infection to fascial and/or muscle compartments
Potential Causes
GAS, S. aureus, or anaerobic streptococci
Epidemiology
Less common in children
Risk factors
NSAIDs
Diabetes
Venous insufficiency Completely normal hosts
Conventional Treatment
Extensive debridement, surgery
Monomicrobial – clindamycin + penicillin G
Polymicrobial – Ampicillin, clindamycin, and ciprofloxacin
Complications
Usually bacteremic
30-60% mortality