1. Necrotizing Fasciitis ALTIN VESELI

2. What is Necrotizing Fasciitis? Hippocrates in the 15th century BC, spoke of it as a complication of erysipelas. Flesh eating bacteria Group A streptococcus(Streptococcus pyogenes), Staphylococcus aureus, Clostridium perfringens. Type 1 (Polymicrobial),Type 2 (Monomicrobial)

3. Erysipelas:Red Skin

4. How does it work? Bacteria enter the body through a break in the skin Paper cuts, Scrape, Burn, Surgical wound. Progresses very rapidly Immunosuppressed individuals(diabetics, elderly, liver disease, AIDS,chemotherapy) Healthy, strong immune system, practice good hygiene and proper wound care.

5. Diagnosis The Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score It uses 6 serologic measures: C-reactive protein, total WBC count, hemoglobin, creatinine and glucose. <6 indicates that necrotizing fasciitis should seriously be considered. >6 Higher rate of mortality and amputation.

6. Symptoms Similar and difficult to differentiate from cellulitis Severe pain in the affected area. Redness, Swelling, Hot skin Fever, Chills, Fatigue may follow the initial wound or soreness. Skin discoloration(violet), blisters, discharge of dish-water like fluid.

7. Patient developed rapidly progressive painful erythema and edema following a bee sting. Necrotizing fasciitis was diagnosed.

8. Patient in the healing process

9. Treatment Early diagnosis=Early treatment Intravenous antibiotic therapy(piperacillin/tazobactam, vancomycin, and clindamycin) Intravenous immunoglobulin Surgery(depridement) Amputation of affected limb Hyperbaric oxygen therapy

10. Notable cases 2004: Eric Allin Cornell, winner of the 2001 Nobel Prize in Physics, lost his left arm and shoulder to the disease. 2012: Aimee Copeland, a 24-year-old graduate student, contracted necrotizing fasciitis after she fell from a zip-line into the Little Tallapoosa River which caused a deep cut in her leg. Copeland’s entire leg was amputated along with her other limbs as a side effect of the disease and treatment. Five of her organs also failed as a result of the ordeal.

11. References https://en.wikipedia.org/wiki/Necrotizing_fa sciitishttps://en.wikipedia.org/wiki/Necrotizing_fa sciitis http://www.cdc.gov/features/necrotizingfas ciitis/http://www.cdc.gov/features/necrotizingfas ciitis/ http://www.medscape.com/viewarticle/444 061_4http://www.medscape.com/viewarticle/444 061_4 http://www.medicinenet.com/necrotizing_f asciitis/page3.htmhttp://www.medicinenet.com/necrotizing_f asciitis/page3.htm