Necrotizing Fasciitis
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 ~ 700-1150 cases/yr annually since 2010.
- Tracked by the CDC through their Active Bacterial Core surveillance program.
- 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.
- Thought to be the most common cause. CDC estimates ~ 700-1150 cases/yr annually since 2010.
- Some also use Type III, designating NF due to clostridial causing gas gangrene.
- Clostridia perfringens is most common; see module for details.
- Other Clostridial spp. include C. noyyi, C. septicum, C. histolyticum and C. sordelli.
- Clostridia perfringens is most common; see module for details.
- Other pathogens that may cause NF
- Other Streptococcal species
- 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 ~ 700-1150 cases/yr annually since 2010.
- Tracked by the CDC through their Active Bacterial Core surveillance program.
- 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.
- Thought to be the most common cause. CDC estimates ~ 700-1150 cases/yr annually since 2010.
- Some also use Type III, designating NF due to clostridial causing gas gangrene.
- Clostridia perfringens is most common; see module for details.
- Other Clostridial spp. include C. noyyi, C. septicum, C. histolyticum and C. sordelli.
- Clostridia perfringens is most common; see module for details.
- Other pathogens that may cause NF
- Other Streptococcal species
- 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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