Johns Hopkins ABX Guide
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 the most common; see module for details.
- Other Clostridial spp. include C. noyyi, C. septicum, C. histolyticum and C. sordelli.
- Clostridia perfringens is the 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.
-- To view the remaining sections of this topic, please log in or purchase a subscription --
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 the most common; see module for details.
- Other Clostridial spp. include C. noyyi, C. septicum, C. histolyticum and C. sordelli.
- Clostridia perfringens is the 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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Last updated: January 23, 2023
Citation
Auwaerter, Paul G. "Necrotizing Fasciitis." Johns Hopkins ABX Guide, The Johns Hopkins University, 2023. Johns Hopkins Guide, www.hopkinsguides.com/hopkins/view/Johns_Hopkins_ABX_Guide/540378/all/Necrotizing_Fasciitis.
Auwaerter PG. Necrotizing Fasciitis. Johns Hopkins ABX Guide. The Johns Hopkins University; 2023. https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_ABX_Guide/540378/all/Necrotizing_Fasciitis. Accessed January 28, 2023.
Auwaerter, P. G. (2023). Necrotizing Fasciitis. In Johns Hopkins ABX Guide. The Johns Hopkins University. https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_ABX_Guide/540378/all/Necrotizing_Fasciitis
Auwaerter PG. Necrotizing Fasciitis [Internet]. In: Johns Hopkins ABX Guide. The Johns Hopkins University; 2023. [cited 2023 January 28]. Available from: https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_ABX_Guide/540378/all/Necrotizing_Fasciitis.
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