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Necrotizing Soft Tissue Infections
Abstract
Necrotizing soft tissue infections occur after traumatic injuries, minor skin lesions, nonpenetrating injuries, natural childbirth, and in postsurgical and immunocompromised patients. Infections can be severe, rapidly progressive, and life threatening. Survivors often endure multiple surgeries and prolonged hospitalization and rehabilitation. Despite subtle nuances that may distinguish one entity from another, clinical approaches to diagnosis and treatment are highly similar. This review describes the clinical and laboratory features of necrotizing soft tissue infections and addresses recommended diagnostic and treatment modalities. It discusses the impact of delays in surgical debridement, antibiotic use, and resuscitation on mortality, and summarizes key pathogenic mechanisms.
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- Stevens DL, Bryant AE. Severe group A streptococcal infections. In: Ferretti JJ, Stevens DL, Fischetti VA, editors. Streptococcus pyogenes: basic biology to clinical manifestations. NCBI e-book; Bookshelf ID: NBK333425; 2016:PMID: 26866227.
- Stevens, 1988, Recurrent gas gangrene at a site of remote injury: localization due to circulating antitoxin, West J Med, 148, 204
- Stevens DL, Shelly MP, Stiller R, Villasenor-S.A., Bryant AE. Acute reversible cardiomyopathy in patients with streptococcal toxic shock syndrome. Proceedings of the XVIIth Lancefield International Symposium on Streptococci and Streptococcal Diseases, 179. Porto Heli, Greece, 2008. Ref Type: Abstract.
- Clinical and Laboratory Standards Institute. Performance Standards for antimicrobial susceptibility testing; 30th edition. CLSI Supplement M100 2020.
- Leal, 2008, Epidemiology of Clostridium species bacteremia in Calgary, Canada, 2000-2006, J Infect, 57, 198
- Kadri, 2017, Impact of intravenous immunoglobulin on survival in necrotizing fasciitis with vasopressor-dependent shock: a propensity score-matched analysis from 130 US Hospitals, Clin Infect Dis, 64, 877, 10.1093/cid/ciw871 · DOI
Cited by
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Metadata
- Authors
- Stevens, D. L., Bryant, A. E., & Goldstein, E. J.
- Affiliations
- Boise VA Medical Center (US)
- Idaho State University (US)
- University of California, Los Angeles (US)
- Corresponding author
- Bryant, Amy E.
- ORCID
- Stevens, Dennis L.
- Venue
- Infectious Disease Clinics of North America
- Publisher
- Elsevier BV
- Published
- 2021-03
- Volume
- 35
- Issue
- 1
- Pages
- 135-155
- ISSN
- 0891-5520 (ISSN-L)
- OpenAlex
- W3022945043
- Cited by
- 113
- References
- 103
- Citations by year
- 2026: 18 · 2025: 28 · 2024: 22 · 2023: 18 · 2022: 14 · 2021: 7
- FWCI
- 1.65
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.elsevier.com/tdm/userlicense/1.0/ (tdm)
- www.elsevier.com/legal/tdmrep-license (tdm)
- Locations
- Infectious Disease Clinics of North America (publishedVersion)
- PubMed (publishedVersion)
- Current treatment options in infectious diseases/Current treatment options in infectious disease
- Topics
- Health Sciences › Medicine › Infectious Diseases › Streptococcal Infections and Treatments
- Health Sciences › Medicine › Infectious Diseases › Otolaryngology and Infectious Diseases
- Health Sciences › Medicine › Infectious Diseases › Clostridium difficile and Clostridium perfringens research
- Keywords
- necrotizing soft tissue infection, soft tissue necrosis, traumatic injury, immunocompromised patients, postoperative infection, clinical features, laboratory diagnosis, surgical debridement, antibiotic therapy, resuscitation, mortality, pathophysiological mechanisms
- MeSH terms
- Anti-Inflammatory Agents, Non-Steroidal, Anti-Bacterial Agents, Clostridium, Combined Modality Therapy, Debridement, Female, Gas Gangrene, Hospitalization, Humans, Magnetic Resonance Imaging, Male, Streptococcal Infections, Streptococcus pyogenes, Tomography, X-Ray Computed, Soft Tissue Infections, Fasciitis, Necrotizing, Coinfection
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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Data sources
Bibliographic data: Semantic Scholar, OpenAlex, Crossref.
Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.