Necrotizing fasciitis: a life-threatening form of soft tissue infection

Necrotizing fasciitis is a rare but severe form of soft tissue infection with a high mortality. After pathogens breach the skin barrier, e.g. due to trauma, a rapid spread along the connective tissue septa and fascia is typical for necrotizing fasciitis. The production of endotoxins and exotoxins in deep lying tissues can elicit a severe surrounding inflammatory reaction resulting in soft tissue necrosis. The worldwide incidence of this disease varies between 0.30 and 15 cases per 100,000 inhabitants. Different causative spectra of pathogens necessitate a different classification of the disease. Treatment should be carried out as quickly as possible in a suitable center with a surgical department experienced in the treatment of necrotizing fasciitis. The initiation of a calculated antibiotic treatment and immediate radical surgical debridement are essential for successful treatment, despite high mortality rates between 16.3% and 36.3%, even with optimal diagnostics and treatment.