Necrotizing fasciitis in rheumatic diseases
Copyright policy )Necrotizing fasciitis in rheumatic diseases
Necrotizing fasciitis is an uncommon but life-threatening complication in immunocompromised hosts. We reported four patients with rheumatic diseases complicated by necrotizing fasciitis and reviewed 14 others from literature search. Most patients were on corticosteroid treatment. Septic shock, disseminated intravascular coagulopathy and acute renal deterioration were common giving rise to an overall mortality rate of 27.8%. Septic arthritis may also complicate the condition. Statistical analysis on the series showed the lack of major surgical debridement as the only risk factor associated with increased mortality (RR 7.5, 95% CI 2.1-27.3, P = 0.01). Timely debridement of necrotic tissue is important for reducing mortality.
- Queen Mary University of London United Kingdom
- Hospital Authority China (People's Republic of)
- University of Hong Kong (香港大學) China (People's Republic of)
- Queen Mary Hospital China (People's Republic of)
- University of Hong Kong China (People's Republic of)
Prednisolone - adverse effects - therapeutic use, Arthroplasty, Replacement, Hip, Replacement, Fasciitis, Necrotizing - drug therapy - etiology - surgery, Scleroderma, Arthritis, Rheumatoid, Fishes - microbiology, Fatal Outcome, Femur Head Necrosis, Diffuse - complications - drug therapy, Gram-Negative Bacterial Infections - drug therapy - etiology - surgery, Fasciitis, Fishes, Shock, Skin Transplantation, Middle Aged, Combined Modality Therapy, Anti-Bacterial Agents, Anti-Bacterial Agents - therapeutic use, Rheumatoid - complications - drug therapy, Female, Aeromonas, Infection, Immunosuppressive Agents, Adult, Arthritis, Infectious - etiology, Immunocompromised hosts, Necrotizing - drug therapy - etiology - surgery, Arthroplasty, Femur Head Necrosis - chemically induced - surgery, Immunocompromised Host, Immunosuppressive Agents - adverse effects - therapeutic use, Skin - injuries, Animals, Humans, Surgical Wound Infection - etiology, Fasciitis, Necrotizing, Disseminated Intravascular Coagulation - etiology, Cyclophosphamide, Arthritis, Infectious, β-haemolytic streptococcus, Hip, Lupus Erythematosus, Pseudomonas Infections - drug therapy - etiology - surgery, Arthritis, Immunocompromised hosts, β-haemolytic streptococcus, Infectious - etiology, Septic - etiology, Disseminated Intravascular Coagulation, Debridement, Systemic - complications - drug therapy, Arthritis, Rheumatoid - complications - drug therapy, Shock, Septic - etiology, Cyclophosphamide - adverse effects - therapeutic use, Gram-Negative Bacterial Infections, Lupus Erythematosus, Systemic - complications - drug therapy, Streptococcal Infections - drug therapy - etiology - surgery, Scleroderma, Diffuse - complications - drug therapy, Aeromonas - isolation & purification
Prednisolone - adverse effects - therapeutic use, Arthroplasty, Replacement, Hip, Replacement, Fasciitis, Necrotizing - drug therapy - etiology - surgery, Scleroderma, Arthritis, Rheumatoid, Fishes - microbiology, Fatal Outcome, Femur Head Necrosis, Diffuse - complications - drug therapy, Gram-Negative Bacterial Infections - drug therapy - etiology - surgery, Fasciitis, Fishes, Shock, Skin Transplantation, Middle Aged, Combined Modality Therapy, Anti-Bacterial Agents, Anti-Bacterial Agents - therapeutic use, Rheumatoid - complications - drug therapy, Female, Aeromonas, Infection, Immunosuppressive Agents, Adult, Arthritis, Infectious - etiology, Immunocompromised hosts, Necrotizing - drug therapy - etiology - surgery, Arthroplasty, Femur Head Necrosis - chemically induced - surgery, Immunocompromised Host, Immunosuppressive Agents - adverse effects - therapeutic use, Skin - injuries, Animals, Humans, Surgical Wound Infection - etiology, Fasciitis, Necrotizing, Disseminated Intravascular Coagulation - etiology, Cyclophosphamide, Arthritis, Infectious, β-haemolytic streptococcus, Hip, Lupus Erythematosus, Pseudomonas Infections - drug therapy - etiology - surgery, Arthritis, Immunocompromised hosts, β-haemolytic streptococcus, Infectious - etiology, Septic - etiology, Disseminated Intravascular Coagulation, Debridement, Systemic - complications - drug therapy, Arthritis, Rheumatoid - complications - drug therapy, Shock, Septic - etiology, Cyclophosphamide - adverse effects - therapeutic use, Gram-Negative Bacterial Infections, Lupus Erythematosus, Systemic - complications - drug therapy, Streptococcal Infections - drug therapy - etiology - surgery, Scleroderma, Diffuse - complications - drug therapy, Aeromonas - isolation & purification
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