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Table 5 Treatment options classified by type of infection and clinical picture

From: Necrotizing fasciitis: literature review of contemporary strategies for diagnosing and management with three case reports: torso, abdominal wall, upper and lower limbs

Type of NSTI

Depth of involvement

Usual pathogens

Predisposing factors

Time of incubation and rate of progression

The main clinical signs

Treatment options

Polymicrobial NF-type I

fascia and muscle

obligate and facultative anaerobes

different type of wounds

long

(48-96 h) Hour to days

foul- smelling drainage

ICU stay

critical care therapy

surgery

antibiotics

ev. HBO

Monomicrobial

NF-type II

(Steptococcal gangrene)

skin, fascia and muscle

Streptococci -groups A, C, G, and B;

(B is more common)

excoriation or cut wound

short

(6-48 h)

A few hour

distinct margins

ICU stay

critical care therapy

surgery

antibiotics

ev. HBO

Gas gangrene

(Clostridial myonecrosis)

muscle

C. perfirngens

(C. perfirngens more common) and C. novyi

tidy wounds

short

(6-48 h)

A few hour

extreme system toxicity

ICU stay

critical care therapy

surgery

antibiotics

HBO

  

C. septicum

gastrointestinal lesion

   

Non-Clostridial myonecrosis

muscle and fascia

obligate and facultative anaerobes or A. hydrophila

different type of wounds

variable

(12-96 h) Hour to days

gas in soft tissue

ICU stay

critical care therapy surgery

antibiotics

HBO