Review Question - QID 1369

The above clinical vignette is describing necrotizing fasciitis. Necrotizing fasciitis is a rare and often fatal soft-tissue infection that requires high clinical suspicion and prompt administration of broad-spectrum antibiotics and aggressive surgical debridement (illustrations A). Fontes et al found that although polymicrobial infections including gram-positive, gram-negative, aerobic, and anaerobic bacteria were found most commonly in necrotizing fasciitis, Group A streptococcus was the most common bacterial isolate. Wong et al also found the most isolated organism to be group A streptococcus. In their study, the highest associated medical comorbidity was diabetes mellitus (71%). They found that delay in surgery of more than 24 hours was correlated with increased risk of death.