Archives of Gynecology and Obstetrics

, Volume 255, Issue 3, pp 153–155 | Cite as

Necrotizing fasciitis arising from episiotomy

  • G. Häusler
  • E. Hanzal
  • C. Dadak
  • W. Gruber
Case Reports

Abstract

Necrotizing fasciitis is a fatal, rapidly progressive, often initially unrecognized condition. Mortality rates range from 30% to 76%. Prognosis depends on the delay of diagnosis, antimicrobial treatment and surgical excision of all necrotic tissue. A case of postpartum perineal necrotizing fasciitis arising from episiotomy is presented. Prompt recognition and aggressive therapy resulted in a favorable outcome despite significant morbidity.

Key words

Necrotizing facsciitis Episiotomy 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Brewer GE, Meleney FL (1926) Progressive gangrenous infection of the skin and subcutaneous tissues, following operation for acute perforate appendicitis. Ann Surg 84:438–450CrossRefPubMedGoogle Scholar
  2. Cullen TS (1924) A progressively enlarging ulcer of the abdominal wall involving the skin and fat, following drainage of an abdominal abscess apparently of appendical origin. Surg Gynecol Obstet 38:579–582Google Scholar
  3. Ewing TL, Smale LE (1979) Maternal deaths associated with postpartum vulvar edema. Am J Obstet Gynecol 134:173–179PubMedGoogle Scholar
  4. Fisher JR, Conway MJ, Takeshita RT, Sandoval MR (1979) Necrotizing fasciitis: Importance of roentgenographic studies for soft-tissue gas. JAMA 241:803–806CrossRefPubMedGoogle Scholar
  5. Giuliano A, Lewis F, Hadley K, Blaisdell FW (1977) Bacteriology of necrotizing fasciitis. Am J Surg 134:52–56CrossRefPubMedGoogle Scholar
  6. Golde S, Ledger WJ (1977) Necrotizing fasciitis in postpartum patients. A report of four cases. Obstet Gynecol 50:670–673PubMedGoogle Scholar
  7. McGregor JA, Soper DE, Lovell G, Todd JK (1989) Maternal deaths associated with Clostridium sordellii infection. Am J Obstet Gynecol 161:987–995PubMedGoogle Scholar
  8. Rea WJ, Wyrick WJ (1970) Necrotizing fasciitis. Ann Surg 172:957–964PubMedGoogle Scholar
  9. Roberts DB, Hester LL (1972) Progressive synergistic bacterial gangrene arising form abscesses of the vulva and Bartholin’s gland duct. Am J Obstet Gynecol 114:285–291PubMedGoogle Scholar
  10. Stamenkovic I, Lew PD (1984) Early recognition of potentially fatal necrotzing fasciitis. New Engl Med 310:1689–1693CrossRefGoogle Scholar
  11. Stone HH, Martin JD (1972) Synergistic necrotizing cellulitis. Ann Surg 175:702–710PubMedGoogle Scholar
  12. Sutton GP, Smirz LR, Clark DH, Bennett JE Group B (1985) Streptococcal necrotizing fasciitis arising from an episiotomy. Obstet Gynecol 66:733–736PubMedGoogle Scholar
  13. Wilson B (1952) Necrotizing fasciitis. Am Surg 18:416–431PubMedGoogle Scholar

Copyright information

© Springer-Verlag 1994

Authors and Affiliations

  • G. Häusler
    • 1
  • E. Hanzal
    • 1
  • C. Dadak
    • 1
  • W. Gruber
    • 1
  1. 1.Department of Gynecology and ObstetricsUniversity of Vienna Medical SchoolViennaAustria

Personalised recommendations