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Necrotizing Soft Tissue Infections

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Handbook on Hyperbaric Medicine

Abstract

Anaerobic soft tissue infections are still life-threatening infections. Even if uncommon nowadays, they remain severe conditions because often associated with major systemic effects leading to patient death if not promptly recognized and aggressively treated. Their origins are often traumatic or surgical but they can also develop from an ulcer or a small wound in patients at risk (i.e. diabetics, patients with peripheral vascular disease, etc). Hypoxia, traumatic muscle injury, heavy bacterial contamination as well as errors in antibiotic prophylaxis are major causes. Treatment includes antibiotic therapy adapted to both the anaerobic and associated aerobic bacteria; early and extensive surgical debridement; and intensive Hyperbaric Oxygen Therapy (HBO). Unfortunately, physicians are insufficiently aware of the first sign of these infections which explains why the management is often inadequate initially. Strict preventive measures must be taken to avoid their occurrence

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References

  1. Altemeier W.A., “Diagnosis, classification and general management of gas-producing infections, particularly those produced by Clostridium perfringens”. In: Brown I.W., Cox B.G., (Eds) Proceedings of the Third International Conference on Hyperbaric Medicine, 481–491. National Research Council, Washington, 1966.

    Google Scholar 

  2. Finegold S., “Anaerobic bacteria in human disease”, Academic Press, New York, 1977.

    Google Scholar 

  3. Argamaso R.V. “Synergistic gangrene: case reports”, Plast. Reconstr. Surg., 1966, 39, 16–22.

    Google Scholar 

  4. Bakker D.J. “Pure and mixed aerobic and anaerobic soft tissue infections. Classification and role of hyperbaric oxygen in treatment”, HBO Rev., 1985, 6, 65–96.

    Google Scholar 

  5. Mathieu D., Wattel F., “Infections anaérobies et tissus mous”, In: Wattel F., Mathieu D. (Eds) Oxygénothérapie hyperbare et réanimation, pp 93–118, Masson, Paris, 1990.

    Google Scholar 

  6. Kaiser R.E., Cerra F.B., “Progressive necrotizing surgical infection — The unified approach”, J. Trauma., 21, 349–355, 1981.

    PubMed  CAS  Google Scholar 

  7. Bartlett J.G. “Anaerobic bacteria: general concepts.” In: Mandell G., Douglas R., Bennett J. (Eds) Principles and practice of infectious diseases, 1828–1850, Churchill Livingstone, New York, 1990.

    Google Scholar 

  8. Loesche W.J., “Oxygen sensibility of various anaerobia bacteria”, Appl. Microbiol., 1969, 18, 723–727.

    PubMed  CAS  Google Scholar 

  9. Rolfe R.D., Hentges D.J., Campbell D.J., Bartlett J.T., “Factors related to the oxygen tolerance of anaerobic bacteria”, Appl. Environ. Microbiol, 1978, 36, 306–313.

    PubMed  CAS  Google Scholar 

  10. Tally F.P., Stewart P.R., Sutter V.L., Rosenblatt J.E., “Oxygen tolerance of fresh clinical anaerobic bacteria”, J. Clin. Microbiol., 1975, 1, 161–164.

    PubMed  CAS  Google Scholar 

  11. Avril J.L., Dabernat H., Dewis F., Monteil H., “Bacilles à Gram négatif anaérobies”. In: Bactériologie clinique, 371–384, Ellipses, Paris, 1992.

    Google Scholar 

  12. Sebald M., “Clostridium”, In: Le Minor L., Veron M., (Eds) Bacteriologie Medicale, 586–626, Flammarion, Paris 1982.

    Google Scholar 

  13. Mc Lennan J.D., “The histotoxic clostridial infections of man”, Bacteriol. Rev., 1962, 26, 177–276.

    Google Scholar 

  14. Gorbach S.L., Bartlett J.G., “Anaerobic infections”, N. Engl. J. Med., 1974, 290, 1177–1184 et 1237–1245.

    Article  PubMed  CAS  Google Scholar 

  15. Hewlet E., “Toxins and other virulence factors”. In: Mandell G., Douglas R., Bennett J. (Eds) Principle and practice of infections diseases. 2–9, Churchill livingstone, New York, 1990.

    Google Scholar 

  16. Hofstad T., “Pathogenicity of anaerobic Gram-negative rods: possible mechanisms”, Rev. Infect. Dis., 1984, 6, 189–199.

    PubMed  CAS  Google Scholar 

  17. Brook I., “Enhancement of growth of aerobic and facultative bacteria in mixed infection with bacteroides species”, Infect. Immun., 1985, 50, 929–932.

    PubMed  CAS  Google Scholar 

  18. Rotstein O., Pruett T., Simmons R., “Mechanisms of microbial synergic in polymicrobial surgical infections”, Rev. Infect. Dis. 1985, 7, 151–170.

    PubMed  CAS  Google Scholar 

  19. Styrt B., Gorbach S.L., “Recent developments in the understanding of the pathogenesis and treatment of anaerobic infections”, N. Engl. J. Med., 1989, 321, 240–243 et 298–301.

    Article  PubMed  CAS  Google Scholar 

  20. Heimbach R.D., “Gas gangrene:review and update”, HBO Rev., 1980, 1, 41–61.

    Google Scholar 

  21. Tempe J.D., Hasselman M., Lutun P., Guiot P., “Les myonécroses clostridiales des membres”, In: Wattel F., Mathieu D. (Eds) Oxygénothérapie hyperbare et réanimation, 84–92, Masson, Paris, 1990.

    Google Scholar 

  22. Hart G.B., Lamb R.C., Strauss M.B. “Gas gangrene: I. A collective review II. A 15 year experience with hyperbaric oxygen”, J. Trauma, 1983, 23, 991–1000.

    PubMed  CAS  Google Scholar 

  23. Bartlett J.G. “Gas gangrene and other Clostridium associated diseases.” In: Mandell G., Douglas R., Bennett J. (Eds) “Principles and practice of infectious diseases”, 1850–1860. Churchill Livingstone, New York, 1990.

    Google Scholar 

  24. Brun-Buisson C., Saada M., Trunet P., Rapin M., Roujeau J.C., Revuz J., “Haemolytic streptococcal gangrene and non steroidal anti-inflammatory drugs”, Br. Med. J., 1985, 290, 1786.

    Article  CAS  Google Scholar 

  25. Van Hook R., Vandervelde A.G., “Gas gangrene after intramuscular injection of epinephrine: report of a fatal case”, Ann. Intern. Med., 1975, 83, 669–670.

    PubMed  Google Scholar 

  26. Moine P., Elkharrat D., Guincestre J.M., Gajdos P., “Gangrène gazeuse après chirurgie orthopédique aseptique”, Presse Med., 1989, 18, 675–678.

    PubMed  CAS  Google Scholar 

  27. Nordkild P., Crone P., “Spontaneous clostridial myonecrosis. A collective review and report of a case”, Ann. Chir. Gynecol., 1986, 75, 274–279.

    CAS  Google Scholar 

  28. Goulon M., Pechere J.C. “Gangrènes gazeuses. Etude multicentrique française réunissant 778 cas”, In: Les anaérobies: microbiologie, pathologie, 185–299, Masson, Paris, 1981.

    Google Scholar 

  29. Meleney F.L., “Hemolytic streptococcus gangrene”, Arch. Surg., 1924, 9, 317–364.

    Google Scholar 

  30. Wilson B., “Necrotizing fasciitis”, Am. Surgeon., 1952, 18, 426–431.

    Google Scholar 

  31. Bahna M., Canalis R., “Necrotizing fasciitis (streptococcal gangrene) of the face”, Arch. Otolaryngol., 1980, 106, 648–651.

    PubMed  CAS  Google Scholar 

  32. Crosthwait R.W. Jr., Crosthwait R.W., Jordan G.L. “Necrotizing fasciitis”, J. Trauma., 1964, 4, 149–157.

    PubMed  Google Scholar 

  33. Freeman H.P., Oluwole S.F., Ganepola G.A., DY E. “Necrotizing fasciitis”, Am. J. Surg., 1981, 142, 377–383.

    Article  PubMed  CAS  Google Scholar 

  34. Jones R.B., Hirschmann J.V., Brown G.S. et al. “Fournier’s syndrome: necrotizing subcutaneous infection of the male genitalia”,. J. Urol., 1979; 122, 279–282.

    PubMed  CAS  Google Scholar 

  35. Darke S.G., King A.M., Slack W.K., “Gas gangrene and related infections: classification, clinical features and aetiology, management and mortality. A report of 88 cases”, Br. J. Surg., 1977, 64, 104–112.

    PubMed  CAS  Google Scholar 

  36. Simmons R.L., Arenholz D.H., “Infections of the skin and soft tissues”, In: Simmons R.L., Howard R.J., (Eds) Surgical Infections Diseases, 507–583, Appleton Century Crofts, New York 1982.

    Google Scholar 

  37. Altemeier W.A., Culbertson W.R., “Acute non-clostridial crepitant cellulitis”, Surg. Gynecol. Obstet., 1948, 87, 206–212.

    PubMed  CAS  Google Scholar 

  38. Stone H.H., Martin J.G. Jr., “Synergistic necrotizing cellulitis”, Am. Surg., 1972, 175, 702–711.

    CAS  Google Scholar 

  39. Fournier A., “Gangrene foudroyante de la verge”, Sem. Med., 1883, 3, 345–347 et 1884, 4, 69–70.

    Google Scholar 

  40. Nickel J.C., Morales A., “Necrotizing fasciitis of the male genitalia (Fournier’s gangrene)”, Can. Med. Assoc. J., 1983, 129, 445–449.

    PubMed  CAS  Google Scholar 

  41. Rudolph R., Soloway M., De Palma R.G., Persky L., “Fournier’s syndrome: synergistic gangrene of the scrotum”, Am. J. Surg. 1975, 129, 591–595.

    Article  PubMed  CAS  Google Scholar 

  42. Meleney F.L., “Bacterial synergism in disease process, with confirmation of the synergistic bacterial etiology of a certain type of progressive gangrene of the abdominal wall”, Ann. Surg., 1933, 94, 961–981.

    Article  Google Scholar 

  43. Brook I., Frazier E.H., “Clinical features and aerobic and anaerobic microbiological characteristics of cellulitis,”. Arch. Surg. 1995, 130, 786–792.

    PubMed  CAS  Google Scholar 

  44. Janevicius R.V., Hann S., Batt M.D., “Necrotizing fasciitis”, Surg. Gynecol. Obstet., 1982, 154, 97–102

    PubMed  CAS  Google Scholar 

  45. Pessa M.E., Howard R.J., “Necrotizing fasciitis”, Surg. Gynecol. Obstet., 1985, 161, 357–361.

    PubMed  CAS  Google Scholar 

  46. Rea W.J., Wyrick W.J., “Necrotizing fasciitis”, Ann. Surg., 1970, 172, 957–964.

    PubMed  CAS  Google Scholar 

  47. Giuliano A., Lewis F., Hadley K., Blaisdell F.W., “Bacteriology of necrotizing fasciitis”. Am. J. Surg., 1977, 134, 52–57.

    Article  PubMed  CAS  Google Scholar 

  48. Durocher A., Fourrier F., Chopin C., Gosselin B., Wattel F., “Cellulites et gangrènes gazeuses: à propos de 100 observations”, Med. Mal. Infect., 1980, 10, 127–132.

    Article  Google Scholar 

  49. Richardson J.B., Fox G.L., Grover F.L., “Necrotizing fasciitis complicating extraction”, Arch. Surg., 1975, 110, 129.

    PubMed  CAS  Google Scholar 

  50. Durocher A., Fourrier F., Collet A., Gosselin B., Chopin C., Wattel F., “Gangrènes gazeuses abdominales post-opératoires”, In: Les anaérobies, Microbiologie, pathologie, 243–252, Masson, Paris, 1981.

    Google Scholar 

  51. Jacobson J.M., Hirschman S.Z., “Necrotizing fasciitis complicating intravenous drug abuse”, Arch. Intern. Med., 1982, 142, 134–135.

    Article  Google Scholar 

  52. Summanen P.H., Talan D.A., Strong C., Mc Teague M., Bennion R., Thompson J.E., Vaisanen M.L., Moran G., Winer M., Finegolg S.M., “Bacteriology of skin and softtissue infections: comparison of infections in intravenous drug users and individuals with no history of intravenous drug use”, Clin. Infect. Dis., 1995, 20, S 279–282.

    Google Scholar 

  53. Green R.J., Dafoe D.C., Raffin T.A., “Necrotizing fasciitis”, Chest, 1996, 110, 219–229.

    PubMed  CAS  Google Scholar 

  54. Fisher J.R., Conway M.J., Takeshita R.T., Sandoval R. “Necrotizing fasciitis: importance of roentgenographic studies for soft-tissue gas”, JAMA, 1979, 241: 803–806.

    Article  PubMed  CAS  Google Scholar 

  55. Sonoda A., Mackawa Y., Arao T. “Spontaneous gangrene of the scrotum and penis (Fournier’s gangrene)”, J. Dermatol., 1980, 7: 371–376.

    PubMed  CAS  Google Scholar 

  56. Bubrick M.P., Hitchcock C.R. “Necrotizing anorectal and perineal infections”, Surgery, 86, 655–659, 1979.

    PubMed  CAS  Google Scholar 

  57. Changyul O., Chongwook L., Jacobson J.H. “Necrotizing fasciitis of perineum”, Surgery, 1982, 91: 49–51.

    Google Scholar 

  58. Wattel F., Ohresser Ph., Mathieu D., Durand-Gasselin J., Vanalbada T. “Perineal gangrene. Clinical presentation and management”, J. Hyperbaric Med., 1986, 1: 215–221.

    Google Scholar 

  59. Barlett J., Gorbach S. “Anaerobic infections of the head and neck”, Otolaryngol. Clin. North Am., 1976, 9: 655–678.

    Google Scholar 

  60. Busch D.F. “Anaerobes in infections of the head and neck and ear, nose, and throat”, Rev. Infect. Dis., 1984, 6: S115–S122.

    PubMed  Google Scholar 

  61. Mathieu D., Neviere R., Teillon C., Chagnon J.L., Lebleu N., Wattel F. “Cervical necrotizing fasciitis: clinical manifestations and management”, Clin. Infect. Dis. 1995, 21: 51–56.

    PubMed  CAS  Google Scholar 

  62. Wenig B.L., Shikowitz M.S., Abramson A.L. “Necrotizing fasciitis as a lethal complication of peritonsillar abscess”, Laryngoscope, 1984, 94: 1576–1579.

    PubMed  CAS  Google Scholar 

  63. Gibbons R.J. “Aspects of the pathogenicity and ecology of the indigenous oral flora of man”, In: Balows. A., De Haan. R.M., Dowell V.R., Guze L.B. Anaerobic bacteria: role in disease, pp 267–285, Sprinfield Ill, New York, 1974.

    Google Scholar 

  64. Krespi Y.P., Lawson W., Blaugrund S.M. “Massive necrotizing infections of the neck”, Head Neck Surg., 1981, 3: 475–481.

    PubMed  CAS  Google Scholar 

  65. Mathieu D., Neviere R., Lefebvre-Lebleu N., Wattel F. “Les infections anaérobies des tissus mous”, Ann. Chir., 1997, 51: 272–287.

    PubMed  CAS  Google Scholar 

  66. Estrera A.S., Landay M.J., Grisham J.M. “Descending necrotizing mediastinitis”, Surg. Gynecol. Obstet., 1983, 157: 545–552.

    PubMed  CAS  Google Scholar 

  67. Levine T.M., Wurster C.F., Krespi Y.P. “Mediastinitis occuring as a complication of ondotogenic infections”, Laryngoscope, 1986, 96: 747–750.

    PubMed  CAS  Google Scholar 

  68. Moreland L.W., Corey J., Mc Kenzie R. “Ludwig’s angina. Report of a case and review of the litterature”, Arch. Intern. Med., 1988, 148: 461–468.

    Article  PubMed  CAS  Google Scholar 

  69. Brewer G.E., Meleney F.L. “Progressive gangrenous infection of the skin and subcutaneous tissues, following operation for acute perforative appendicitis”, Ann. Surg., 1926, 84: 438–450.

    Article  PubMed  CAS  Google Scholar 

  70. Meleney F.L. “A differential diagnosis between certain types of infectious gangrene of the skin, with particular reference to hemolytic streptococcus gangrene and bacterial synergistic gangrene”, Surg. Gynecol. Obstet., 1933, 56: 847–864.

    Google Scholar 

  71. Ledingham I.M.C.A., Tehrani M.A. “Diagnosis, clinical course and treatment of acute dermal gangrene”, Br. J. Surg., 1975, 52: 364–372.

    Google Scholar 

  72. Cullen T.S. “A progressively enlarging ulcer of abdominal wall involving the skin and fat, following drainage of an abdominal abscess apparently of appendiceal origin”, Surg. Gynecol. Obstet., 1924, 38: 579–582.

    Google Scholar 

  73. Dubreuil L., Devos J., Neut C., Romond C. “Etude de la sensibilité antibiotique des anaérobies stricts”, Med. Mal. Infect., 1983, 13: 478–483.

    Google Scholar 

  74. Sire J.M., Mesnard R., Hercouet H., Pouedras P., Avril J.L. “Sensibilité de Bacteroides, Clostridium et Fusobacterium. Etude de 10 antibiotiques sur 260 souches”, Méd. Mal. Infect., 1990, 20: 589–594.

    Article  Google Scholar 

  75. Tally F.P., Cuchural G.J., Jacobus N.V., Gorbach S.L., Aldridge K., Cleary T. et al. “Nation wide study of susceptibility of the bacteroides fragilis group in the United States”, Antimicrob. Agents Chemother., 1985, 28: 675–677.

    PubMed  CAS  Google Scholar 

  76. Finegold S. M. “Treatment of anaerobic infections: an overview”, Scand. J. Inf. Dis., 1985, 46suppl.: 89–95.

    CAS  Google Scholar 

  77. Finegold S., Bartlett J., Chow A., Flora D., Gobrbach S., Harder E., Tally F. “Management of anaerobic infections”, Ann. Intern. Med., 1985, 83: 375–389.

    Google Scholar 

  78. Brook I., Hunter V., Walker R.I. “Synergistic effect of Bacteroides, Clostridium, Fusobacterium, anaerobic cocci and aerobic bacteria on mortality and induction of subcutaneous abscesses in mice”, J. Infect. Dis., 1984, 149: 924–928.

    PubMed  CAS  Google Scholar 

  79. Tally F.P., Cuchural G.J., Malamy M.H. “Mechanisms of resistance and resistance transfer in anaerobic bacteria: factors influencing antimicrobial therapy”, Rev. Infect. Dis., 1984, 6, S260–S269.

    PubMed  Google Scholar 

  80. Altemeier W.A., Pullen W.D. “Prevention and treatment of gas gangrene”, JAMA, 1971, 217: 806–813.

    Article  PubMed  CAS  Google Scholar 

  81. Majeski J.A., Alexander J.W. “Early diagnosis, nutritional support, and immediate extensive debridement improve survival in necrotizing fasciitis”, Am. J. Surg., 1983, 145, 784–787.

    Article  PubMed  CAS  Google Scholar 

  82. Baxter C.R. “Surgical management of soft tissue infections”, Surg. Clin. North Am., 1972, 52: 1483–1499.

    PubMed  CAS  Google Scholar 

  83. Barsan M., Dudaim M., Shalev O. “Near-fatal systemic oxygen embolism due to wound irrigation with hydrogen peroxide”, Postgrd. Med J, 1982, 58: 448–450.

    Google Scholar 

  84. Saissy J.M., Guignard B., Pats B., Guiavarch M., Rouvier B. “Pulmonary edema after hydrogen peroxide irrigation of a war wound”, Intensive Care Med. 1995, 21: 287–288.

    Article  PubMed  CAS  Google Scholar 

  85. Mc Henry C.H., Piotrowski J.J., Petrinic D., Malangoni M.A. “Determinants of mortality for necrotizing soft-tissue infections”, Ann. Surg. 1995, 221: 558–565.

    CAS  Google Scholar 

  86. Brummelkamp W.H., Hoogendijk J.L., Boerema I. “Treatment of anaerobic infections (clostridial myositis) by drenching the tissues with oxygen under high atmospheric pressure”, Surgery, 1961, 49: 299–302.

    Google Scholar 

  87. Holland J.A., Hill G.B., Wolfe W.G. et al. “Experimental and clinical experience with hyperbaric oxygen in the treatment of clostridial myonecrosis”, Surgery, 1975, 77: 75–85.

    PubMed  CAS  Google Scholar 

  88. Demello FJ., Haglin J.J., Hitchcock C.R. “Comparative study of experimental Clostridium perfringens infection in dogs treated with antibiotics, surgery and hyperbaric oxygen”, Surgery, 1973, 73: 936–941.

    PubMed  CAS  Google Scholar 

  89. Hill G.B., Osterhout S. “Experimental effects of hyperbaric oxygen on selected clostridial species. In vitro studies. In vivo studies in mice”, J. Infect. Dis., 1972, 125: 17–35.

    PubMed  CAS  Google Scholar 

  90. Hirn M., Niinikoski J., Lehtonen O.P. “Effects of hyperbaric oxygen and surgery on experimental gas gangrene”, Eur. Surg. Res., 1992, 24: 356–362.

    PubMed  CAS  Google Scholar 

  91. Thom S.R., Lauermann M.W., Hart G.B. “Intermittent hyperbaric oxygen therapy for reduction of mortality in experimental polymicrobial sepsis”, J. Infect. Dis., 1986, 154: 504–510.

    PubMed  CAS  Google Scholar 

  92. Zamboni W.A., Mazolewski P.J., Erdmann D et al. “Evaluation of penicillin and hyperbaric oxygen in the treatment of streptococcal myositis”, Ann. Plast.Surg., 1997, 39: 131–136.

    PubMed  CAS  Google Scholar 

  93. Shupak A., Shoshani O., Goldenberg I., Barzilai A., Moskuna R., Bursztein S. “Necrotizing fasciitis: an indication for hyperbaric oxygenation therapy?”, Surgery, 1995, 118: 873–878.

    Article  PubMed  CAS  Google Scholar 

  94. Brown DR., Davis NL., Lepawsky M., Conningham J., Kortbeek J. “A multicenter review of the treatment of major truncal necrotizing infections with and without hyperbaric oxygen therapy”, Am. J. Surg., 1994, 167: 485–489.

    Article  PubMed  CAS  Google Scholar 

  95. Riseman JA., Zamboni WA., Curtis A., Graham DR., Konrad HR., Ross DS. “Hyperbaric oxygen therapy for necrotizing fasciitis reduces mortality and the need for debridement”, Surgery, 1990, 108: 847–850.

    PubMed  CAS  Google Scholar 

  96. “Recommendations of the jury of the 1st European Consensus Conference on Hyperbaric Oxygen Therapy”. In: Oriani G., Marroni A., Wattel F. (Eds) Handbook of Hyperbaric Medicine, pp. 125–134, Springer, Berlin, Milano, 1996.

    Google Scholar 

  97. Rouse T.M., Malangoni M.A., Schulte W.J. “Necrotizing fasciitis: a preventable disaster”, Surgery 1982, 92: 765–769.

    PubMed  CAS  Google Scholar 

  98. Lille S.T., Sato T.T., Engray L.H., Foy H., Jurkovich G.J. “Necrotizing soft-tissue infections: obstacles in diagnosis”, J. Am. Coll. Surg., 1996, 182: 7–11.

    PubMed  CAS  Google Scholar 

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  1. Service d’Urgence Respiratoire, de Réanimation Médicale et de Médecine Hyperbare, Hôpital Calmette, Centre Hospitalier et Universitaire, Lille, France

    Daniel Mathieu, Raphaël Favory, Jean-François Cesari & Francis Wattel

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    Daniel Mathieu

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Mathieu, D., Favory, R., Cesari, JF., Wattel, F. (2006). Necrotizing Soft Tissue Infections. In: Mathieu, D. (eds) Handbook on Hyperbaric Medicine. Springer, Dordrecht. https://doi.org/10.1007/1-4020-4448-8_15

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