48,466
edits
Difference between revisions of "Necrotizing fasciitis"
Jump to navigation
Jump to search
→Microscopic
| (8 intermediate revisions by the same user not shown) | |||
| Line 7: | Line 7: | ||
| Micro = necrotic fascia - amorphous grey or pink material and [[neutrophil]]s | | Micro = necrotic fascia - amorphous grey or pink material and [[neutrophil]]s | ||
| Subtypes = | | Subtypes = | ||
| LMDDx = | | LMDDx = [[vasculitis]] | ||
| Stains = | | Stains = | ||
| IHC = | | IHC = | ||
| Line 15: | Line 15: | ||
| Gross = sloughing, bulae, erythema | | Gross = sloughing, bulae, erythema | ||
| Grossing = | | Grossing = | ||
| Site = [[skin]] | | Site = [[skin]] / subcutaneous tissue | ||
| Assdx = | | Assdx = | ||
| Syndromes = | | Syndromes = | ||
| Clinicalhx = | | Clinicalhx = +/-trauma | ||
| Signs = subcutaneous emphysema, edema, skin sloughing, bulae, erythema, signs of sepsis | | Signs = subcutaneous emphysema, edema, skin sloughing, bulae, erythema, signs of sepsis | ||
| Symptoms = pain | | Symptoms = pain | ||
| Line 27: | Line 27: | ||
| Prognosis = poor | | Prognosis = poor | ||
| Other = | | Other = | ||
| ClinDDx = cellulitis, abscess | | ClinDDx = [[cellulitis]], abscess | ||
| Tx = surgical debridement, antibiotics | | Tx = surgical debridement, antibiotics | ||
}} | }} | ||
| Line 33: | Line 33: | ||
It should '''''not''' to be confused with [[nodular fasciitis]]''. | It should '''''not''' to be confused with [[nodular fasciitis]]''. | ||
In the perineum/genital region it is known as ''Fournier gangrene''.<ref name=pmid23771967>{{Cite journal | last1 = Haemers | first1 = K. | last2 = Peters | first2 = R. | last3 = Braak | first3 = S. | last4 = Wesseling | first4 = F. | title = Necrotising fasciitis of the thigh. | journal = BMJ Case Rep | volume = 2013 | issue = | pages = | month = | year = 2013 | doi = 10.1136/bcr-2013-009331 | PMID = 23771967 }}</ref> | |||
==General== | ==General== | ||
Clinical: | Clinical: | ||
*Pain - | *Pain - classically out-of-keep with appearance. | ||
*Features of sepsis - late. | *Features of sepsis - late. | ||
*Often nonspecific.<ref name=pmid22491537/> | *Often nonspecific.<ref name=pmid22491537/> | ||
| Line 42: | Line 44: | ||
Clinical DDx: | Clinical DDx: | ||
*Abscess. | *Abscess. | ||
*Cellulitis. | *[[Cellulitis]]. | ||
Epidemiology: | Epidemiology: | ||
| Line 80: | Line 82: | ||
DDx: | DDx: | ||
*[[Cellulitis]]. | *[[Cellulitis]]. | ||
*[[Vasculitis]]. | |||
*[[Erythema nodosum]].{{fact}} | |||
===Images=== | ===Images=== | ||
| Line 86: | Line 90: | ||
Image:Necrotizing_fasciitis_-_high_mag.jpg | Necrotizing fasciitis - high mag. (WC) | Image:Necrotizing_fasciitis_-_high_mag.jpg | Necrotizing fasciitis - high mag. (WC) | ||
</gallery> | </gallery> | ||
==Sign out== | |||
<pre> | |||
Perianal Skin and Subcutaneous Tissue, Excision: | |||
- Consistent with clinical impression of necrotizing fasciitis. | |||
</pre> | |||
===Alternate=== | |||
<pre> | |||
Submitted as "Tissue from Left Elbow", Excision: | |||
- Skin and subcutaneous tissue with marked inflammation (see microscopic), | |||
consistent with clinical impression of necrotizing fasciitis. | |||
Comment: | |||
The positive tissue cultures are noted. | |||
</pre> | |||
====Micro==== | |||
Necrotic fascial tissue with inflamed adipose tissue and micro-abscess formation at dermis/subcutis interface. The overlying skin is moderately inflamed and edematous appearing. | |||
==See also== | ==See also== | ||