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A Case Series Describing 118 Patients With Lower Limb Necrotizing Fasciitis

Department of General Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India, akhannabhu{at}gmail.com

Satyendra K. Tiwary, MS

Department of General Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India

Puneet Kumar, MS

Department of General Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India

Rahul Khanna, MS, PhD

Department of General Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India

Anuradha Khanna, MD

Department of Obstetrics and Gynecology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India

Necrotizing fasciitis of the lower limb is not uncommon, with poor outcome. This study reviewed 118 cases (78 males and 40 females) with mean age of 45 + 16.5 years (range 12-95 years) of lower limb necrotizing fasciitis admitted to the Department of Surgery, BHU in India between 1995 and 2007. Most patients (n = 97) presented with fever. Other presenting symptoms included painful swelling, bullae, erythema, ulcer, and necrosis. Comorbid conditions such as diabetes, tuberculosis, malignancy, and immunosuppressive therapy were associated in 72 (61%) cases. Amputations were done in 24 patients. Thirty one patients developed septic shock. Renal dialysis was done in 16 patients and ventilatory support was needed in 12 patients. The most common organism identified was β-hemolytic streptococci (n = 42). Eighteen patients died, a mortality of 15%. The authors consider early diagnosis and aggressive surgical intervention to be crucial for the successful treatment of disease.

Key Words: lower limb necrotizing fasciitis • lower limb • soft tissue infections

The International Journal of Lower Extremity Wounds, Vol. 8, No. 2, 112-116 (2009)
DOI: 10.1177/1534734609334809


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