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:5/26/2016)... (PRWEB) , ... May 26, 2016 , ... ... Retinal Degeneration” for the Foundation Fighting Blindness, Long Island Chapter on June 4, ... the public. , Dr. Maisel, founder of Retina Group of New York ...
(Date:5/26/2016)... , ... May 26, 2016 , ... ... of comprehensive treatment for eating disorders, is opening a brand new child and ... individuals ages 8-17 and their families with even more specialized eating disorder treatment ...
(Date:5/26/2016)... ... ... The MIAMI Institute for Age Management and Intervention celebrates Global Wellness Day with ... Adonis , Wellness Physician of the MIAMI Institute is certified by the American Academy ... , He also heads up FITTLab, the comprehensive medical testing lab located in The ...
(Date:5/26/2016)... Grants Pass, OR (PRWEB) , ... May 26, 2016 , ... ... founder of Bio-Logic Aqua® Research Water Life Science® and international water advocate, was honored ... descendant of the women in ancient Egypt who knelt on the banks of the ...
(Date:5/26/2016)... ... May 26, 2016 , ... Saint Francis ... several years, and the efforts have paid off. Since implementation of these ... of care to enhance perioperative patient experiences and reduce costly complications. Since implementation ...
Breaking Medicine News(10 mins):
(Date:5/25/2016)... 2016 MedDay, a biotechnology company focused ... oral presentation entitled "High doses of biotin in progressive multiple ... given by Professor Ayman Tourbah , Principal Investigator of ... European Academy of Neurology (EAN) in Copenhagen, Denmark ... will take place on Sunday, 29 May 2016 from 14:45 ...
(Date:5/24/2016)... 2016 Cirujanos holandeses han puesto ... los médicos a compartir sus mejores prácticas por el ... Profesionales médicos de Europa, África, Asia ... la aplicación, que combina la transmisión en vivo con ... Educación   "Imagine un médico de ...
(Date:5/24/2016)... New Zealand , May 24, 2016 ... and informatics solutions for the healthcare sector, has been named ... New Zealand Hi-Tech Awards 2016. Dr Bruce ... fantastic acknowledgement for our team.  It,s really good to be ... burden healthcare internationally. Our products are used in 35 countries ...
Breaking Medicine Technology: