Necrotizing Fasciitis

Paul G. Auwaerter, M.D., John G. Bartlett, M.D.

Necrotizing Fasciitis is a topic covered in the Johns Hopkins ABX Guide.

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PATHOGENS

Some classify necrotizing fasciitis (NF) into Type I and Type II.
- Mixed aerobic-anaerobic bacteria [Type I]
- Group A Streptococcus (GAS, S. pyogenes, Type II)
  - Thought to be the most common cause. CDC estimates ~ 700-1200 cases/yr annually since 2010.
  - Certain Streptococcal strains are seen more frequently in NF, most commonly those that contain M protein types 1, 3, 12, and 28 (elaborating pyrogenic exotoxin A).
  - May complicate routine varicella or zoster as superinfeciton.
Other pathogens that may cause NF
- Other Streptococcal species
- Clostridium perfringens
- Staphylococcus aureus
- Vibrio vulnificus
- Aeromonas spp.
- Klebsiella spp.
- Pseudomonas aeruginosa
- Other: host of occasional bacterial pathogens implicated, Candida and Mucor spp. also rarely described.

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PATHOGENS

Some classify necrotizing fasciitis (NF) into Type I and Type II.
- Mixed aerobic-anaerobic bacteria [Type I]
- Group A Streptococcus (GAS, S. pyogenes, Type II)
  - Thought to be the most common cause. CDC estimates ~ 700-1200 cases/yr annually since 2010.
  - Certain Streptococcal strains are seen more frequently in NF, most commonly those that contain M protein types 1, 3, 12, and 28 (elaborating pyrogenic exotoxin A).
  - May complicate routine varicella or zoster as superinfeciton.
Other pathogens that may cause NF
- Other Streptococcal species
- Clostridium perfringens
- Staphylococcus aureus
- Vibrio vulnificus
- Aeromonas spp.
- Klebsiella spp.
- Pseudomonas aeruginosa
- Other: host of occasional bacterial pathogens implicated, Candida and Mucor spp. also rarely described.

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