Pediatric Surgery International

, Volume 21, Issue 8, pp 641–644 | Cite as

Necrotizing fasciitis in neonates

  • Zafar NazirEmail author
Original Article


Necrotizing fasciitis (NF) is a potentially life-threatening infection of soft tissues. It is characterized by rapid spread of inflammation and infection with widespread necrosis of fascia, subcutaneous tissues, and overlying skin. NF is usually reported in adults with preexisting medical conditions or compromised immune system. It is rare in neonates, and the reported mortality is close to 50% in this population. Less than 70 cases of neonatal NF are reported in literature, most in otherwise healthy neonates and usually attributed to omphalitis, mastitis, or postoperative wound infections. We report our experience of nine neonates who developed NF spontaneously (primary NF) and look at the etiology, clinical presentation, microbiology, management, and outcome.


Necrotizing fasciitis Soft tissue infections Neonate Neonatal surgery 


  1. 1.
    Abbott R, Marcus JR, Few JW, Farkas AM, Jona J (1999) Necrotizing fasciitis in infancy: an uncommon setting and a prognostic disadvantage. J Pediatr Surg 34:1432–1434PubMedCrossRefGoogle Scholar
  2. 2.
    Barton LL, Jeck DT (1996) Necrotizing fasciitis in children: report of two cases and review of literature. Arch Pediatr adolesc Med 150:105–108PubMedGoogle Scholar
  3. 3.
    Bodemer C, Panhans A, Chretien-Marquet B, Cloup M, Pellerin D, deProst Y (1997) Staphylococcus necrotizing fasciitis in the mammary region in childhood: a report of five cases. J Pediatr 131:466–469PubMedCrossRefGoogle Scholar
  4. 4.
    Bormar WE, Ferlauto J, Well DH (1980) An unusual presentation of β-hemolytic group B streptococcal infection. J Pediatr Surg 15:683–685PubMedCrossRefGoogle Scholar
  5. 5.
    Childers BJ, Potyondy LD, Nachreiner R, Roger FR, Childers ER, Oberg KC (2002) Necrotizing fasciitis: a fourteen-year retrospective study of 163 consecutive patients. Am Surg 68:109–116PubMedGoogle Scholar
  6. 6.
    Elliott DC, Kufera JA, Myers RAM (1996) Necrotizing soft tissue infections. Ann Surg 224:672–683CrossRefPubMedGoogle Scholar
  7. 7.
    Hsieh T, Samson LM, Jabbour M, Osmond MH (2000) Necrotizing fasciitis in children in eastern Ontario: a case-control study. CMAJ 163:393–396PubMedGoogle Scholar
  8. 8.
    Hsieh WS, Yang PH, Chao HC, Lai JY (1999) Neonatal necrotizing fasciitis: a report of three cases and review of the literature. Pediatrics 0; 103(4) URL: Google Scholar
  9. 9.
    Jaing TH, Huang CS, Chiu CH, Huang YC, Kong MS, Liu WM (2001) Surgical implications of pseudomonas aeruginosa necrotizing fasciitis in a child with acute lymphoblastic leukemia. J Pediatr Surg 36:948–950CrossRefPubMedGoogle Scholar
  10. 10.
    Kosloske AM, Cushing AH, Borden TA, Woodside JR, Klein MD, Kulasinghe HP (1981) Cellulitis and necrotizing fasciitis of the abdominal wall in pediatric patients. J Pediatr Surg 16:246–251PubMedCrossRefGoogle Scholar
  11. 11.
    Lochbuhler H (1988) Necrotizing fasciitis in a neonate. Pediatr Surg Int 3:441–443CrossRefGoogle Scholar
  12. 12.
    Lodha A, Wales PW, James A, Smith CR, Langer JC (2003) Acute appendicitis with fulminant necrotizing fasciitis in a neonate. J Pediatr Surg 38:E53CrossRefGoogle Scholar
  13. 13.
    Fustes-Morales A, Gutierrez-Castrellon P, Duran-Mckinster C, Orozco-Covarrubias L, Tamayo-Sanchez L, Ruiz-Maldonado R (2002) Necrotizing fasciitis: report of 39 pediatric cases. Arch Dermatol 138:893–899CrossRefPubMedGoogle Scholar
  14. 14.
    Mordehai J, Kurzbart E, Cohen Z, Mares AJ (1997) Necrotizing fasciitis and myonecrosis in early childhood: a report of three cases. Pediatr Surg Int 12:538–540PubMedCrossRefGoogle Scholar
  15. 15.
    Moss RL, Musemeche CA, Kosloske AM (1996) Necrotizing fasciitis in children: prompt recognition and aggressive therapy improve survival. J Pediatr Surg 31:1142–1146CrossRefPubMedGoogle Scholar
  16. 16.
    Murphy JJ, Granger R, Blair GK, Miller GG, Fraser GC, Magee JF (1995) Necrotizing fasciitis in childhood. J Pediatr Surg 30:1131–1134CrossRefPubMedGoogle Scholar
  17. 17.
    Sawin RS, Schaller RT, Tapper D, Morgan A, Cahill J (1994) Early recognition of neonatal abdominal wall Necrotizing fasciitis. Am J Surg 167:481–484CrossRefPubMedGoogle Scholar
  18. 18.
    Shaaban H, Bayat A, Davenport P, Shah M (2002) Necrotizing fasciitis in an infant with congenital insensitivity to pain syndrome. Br J Plast Surg 55:160–163CrossRefPubMedGoogle Scholar
  19. 19.
    Stamenkovic I, Lew PD (1984) Early recognition of potentially fetal necrotizing fascitis: the use of frozen-section biopsy. N Engl J Med 310:1689–1693PubMedCrossRefGoogle Scholar
  20. 20.
    Sy ED, Liu CS, Huang SM, Shan YS (2001) Cecal perforation presenting as abdominal wall necrotizing fasciitis. Pediatr Surg Int 17:215–217CrossRefPubMedGoogle Scholar
  21. 21.
    Waldhausen JHT, Holterman M, Sawin RS (1996) Surgical implications of necrotizing fasciitis in children with chicken pox. J Pediatr Surg 31:1138–1141CrossRefPubMedGoogle Scholar
  22. 22.
    Wilson B (1952) Necrotizing fasciitis. Am Surg 18:416–431PubMedGoogle Scholar
  23. 23.
    Yamaoka M, Furusawa K, Uematsu T, Yasuda K (1994) Early evaluation of necrotizing fasciitis with use of CT. J Cranio-Maxillofacial Surg 22:268–271CrossRefGoogle Scholar
  24. 24.
    Zittergruen M, Grose C (1993) Magnetic resonance imaging for early diagnosis of necrotizing fasciitis. Pediatr Emerg Care 9:26–28PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2005

Authors and Affiliations

  1. 1.Section of Paediatric surgery, Department of Surgery, The Aga Khan University HospitalThe Aga Khan UniversityKarachiPakistan

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