Home Necrotizing fasciitis (NF): Monomicrobial

Necrotizing fasciitis (NF): Monomicrobial


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


Less common in children

Risk factors

Venous insufficiency Completely normal hosts

Conventional Treatment

Extensive debridement, surgery
Monomicrobial – clindamycin + penicillin G
Polymicrobial – Ampicillin, clindamycin, and ciprofloxacin


Usually bacteremic
30-60% mortality