Navigation Links
Researchers call for early diagnosis of flesh-eating infections
Date:9/17/2012

New Orleans, LA Dr. Russell Russo, an Orthopedic Surgeon at LSU Health Sciences Center New Orleans, and other researchers stress that orthopedists should have a high index of suspicion for necrotizing fasciitis, or flesh-eating bacterial infection, in every patient with pain or other symptoms that are out of proportion to the initial diagnosis. Their recommendations are published in the September 2012 issue of Orthopedics Today.

Although relatively rare and difficult to diagnose because its symptoms often resemble other conditions like synovitis or cellutitis, a missed diagnosis could lead to amputation or death.

"The infection can rapidly spread at a rate of 1 cm per hour," notes Dr. Russo. "People who have their surgery and debridement within 10 to 24 hours once they hit the door, do much better than the patients for whom the diagnosis is not made for days."

Dr. Russo says a hands-on physical examination is necessary to recognize the condition early because X-rays, CT scans and other imaging tests may not detect the disease and are time-consuming.

"Pain out of proportion to physical findings, nausea, fever, hypotension, mental confusion, loss of sensation, skin discoloration, crepitus or necrosis all signal necrotizing fasciitis," Dr. Russo emphasizes.

Many types of bacteria can cause necrotizing fasciitis, including Group A Streptococcus pyogenes and Group B Streptococcus infections. Clostridium and methicillin-resistant Staphylococcus aureus can also cause the infection. In some cases, patients can have more than one type of bacteria.

Awareness of predisposing risk factors may also aid a faster diagnosis. These include a history of trauma, obesity, rheumatoid arthritis, diabetes, kidney disease, HIV, hepatitis C, and other diseases that compromise the immune system. However, 50% of necrotizing fasciitis cases occur in healthy people, and can result from cuts, insect bites, or blunt trauma. It has been reported in healthy kids who got hit playing football and suddenly contracted necrotizing fasciitis.

"About 45% of patients do not recall obvious injuries, such as cuts, scrapes, injections or bruises that may have led to infections," says Dr. Russo. "If you have a red, warm arm, address it, and do not wait."

Dr. Russo is particularly aware of the risk from intravenous drug use. One of his patients developed the devastating infection after injecting the drugs known as bath salts. The bath salts could have been contaminated, or the source could have been the needle. "Sometimes IV drug users 'grease the needle,' licking the needle prior to injection, which gives you bacteria from your mouth, one of the most bacteria-laden places in the body," notes Dr. Russo.

If a necrotizing infection is suspected, surgeons agree that immediate surgical exploration should be performed, with debridement of necrotic tissue and drainage of fluid collections, aggressive resuscitation, and broad spectrum antibiotics given. Wound vacuums, negative pressure wound therapy systems or hyperbaric oxygen may also help.

The researchers recommend more education, both for the medical community and the public, as well as further research to boost immune response and better manage disease.

Dr. Russo also suggests the development of a combination of tests to rapidly differentiate between cellulitis and necrotizing fasciitis, and until then, an immediate ultrasound upon patient admission.

"I think if these patients are getting ultrasounds when they hit the door as one of the first tests, you can tell if there is a lot of fluid, pus or gas underneath the skin quickly and rule out cellulitis vs. necrotizing fasciitis relatively quickly without needing a CT, an MRI or a bunch of labs," he said. "With this disease, time is serious."


'/>"/>

Contact: Leslie Capo
lcapo@lsuhsc.edu
504-568-4806
Louisiana State University Health Sciences Center
Source:Eurekalert

Related medicine news :

1. UMass Amherst sleep researchers study value of preschool naps
2. Moffitt cancer center researchers find novel predictor for MDS progression risk
3. HF/E researchers examine older adults willingness to accept help from robots
4. Local talent: Global impact public invited to meet world-class researchers at Queens
5. Researchers improve gene therapy technique for children with immune disorder
6. Moffitt researchers say race affect likelihood of finding suitable stem cell donor
7. Researchers closer to understanding actions of cells involved in atherosclerosis
8. Case Western Reserve researchers create short-term memories in-vitro
9. Researchers find first evidence for a genetic cause for Barretts esophagus
10. Researchers show cost-effectiveness of HIV testing in drug abuse treatment programs
11. When clinicians and researchers look outside the box
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/25/2016)... ... ... of Bruton Memorial Library on June 21 due to a possible lice infestation, as reported ... head lice: the parasite’s ability to live away from a human host, and to infest ... in the event that lice have simply gotten out of control. , As lice are ...
(Date:6/25/2016)... CA (PRWEB) , ... June 25, 2016 , ... As ... with Magna Cum Laude and his M.D from the David Geffen School of Medicine ... and returned to Los Angeles to complete his fellowship in hematology/oncology at the UCLA-Olive ...
(Date:6/25/2016)... ... 25, 2016 , ... Conventional wisdom preaches the benefits of moderation, whether it’s ... setting the bar too high can result in disappointment, perhaps even self-loathing. However, those ... goal. , Research from PsychTests.com reveals that behind the tendency to ...
(Date:6/24/2016)... , ... June 24, 2016 , ... June 19, 2016 ... dangers associated with chronic pain and the benefits of holistic treatments, Serenity Recovery ... are suffering with Sickle Cell Disease. , Sickle Cell Disease (SCD) is a disorder ...
(Date:6/24/2016)... ... June 24, 2016 , ... Global law firm Greenberg Traurig, P.A. announced that ... chosen by their peers for this recognition are considered among the top 2 percent ... special honors as members of this year’s Legal Elite Hall of Fame: Miami ...
Breaking Medicine News(10 mins):
(Date:6/24/2016)... , June 24, 2016   Bay Area ... Network,s Dean Center for Tick Borne Illness ... and Rehabilitation, MIT Hacking Medicine, University of California, ... today announced the five finalists of Lyme ... disease.  More than 100 scientists, clinicians, researchers, entrepreneurs, ...
(Date:6/24/2016)... , June 24, 2016 ... the "Structural Electronics 2015-2025: Applications, Technologies, Forecasts" ... In-Mold Electronics, Smart Skin, Structural ... Structural electronics involves electronic and/or ... protective structures, replacing dumb structures such as vehicle ...
(Date:6/24/2016)... , June 24, 2016 Dehaier Medical ... the "Company"), which develops, markets and sells medical devices ... , signed a strategic cooperation agreement with Hongyuan ... "Hongyuan Supply Chain") on June 20, 2016, to develop ... the strategic cooperation agreement, Dehaier will leverage Hongyuan Supply ...
Breaking Medicine Technology: