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Necrotizing cellulitis
From WikEM
Contents
Background
- Patients are often much less toxic compared with necrotizing fasciitis/necrotizing myositis
- Two types:
- Anaerobic infection (clostridial and nonclostridial)
- Meleney's synergistic gangrene
- Rare infection that occurs in postop patients
- Characterized by slowly expanding indolent ulceration that is confined to superficial fascia
- Results from synergistic interaction between S. aureus and microaerophilic streptococci
Risk Factors
- Trauma
- Surgical contamination
- Spread of infection from bowel to perineum, abdominal wall, or lower extremities
Clinical Features
- Thin, dark, sometimes foul-smelling wound drainage (often containing fat globules)
- Tissue gas formation (crepitus)
Differential Diagnosis
Skin and Soft Tissue Infection
- Cellulitis
- Erysipelas
- Lymphangitis
- Abscess
- Necrotizing soft tissue infections
- Necrotizing fasciitis
- Necrotizing myositis
- Necrotizing cellulitis
- Mycobacterium marinum
Look-A-Likes
Necrotizing rashes
- Necrotizing soft tissue infections
- Necrotizing fasciitis
- Necrotizing myositis
- Necrotizing cellulitis
- Purpura fulminans
- Drug rash
- Levamisole toxicity
Evaluation
Management
- Same as Necrotizing Fasciitis
Disposition
- Admit/OR
See Also
References
Authors
Ross Donaldson, Michael Holtz, Neil Young, Daniel Ostermayer
