From: Triple diagnostics for early detection of ambivalent necrotizing fasciitis
Macroscopy | Fresh frozen section | Gram stain |
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• Dishwater pus • Lack of bleeding • Lack of tissue resistance • Grey necrotic tissue • Non-contracting muscles • Fascial oedema • Purple blisters on skin | • Necrosis of superficial fascia • Polymorphonuclear infiltration of the deep dermis and fascia • Fibrinous trombi of arteries and veins passing through the fascia • Angiitis with fibrinoid necrosis of vessel walls • Microorganisms within the destroyed fascia and dermis | • Microbes • With or without leukocytes • Group A Streptococci • Clostridium perfringens • Vibrio species |