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NEKROTIZUJUĆI FASCITIS KAO RETKO AKUTNO ŽIVOTNO UGROŽAVAJUĆA INFEKCIJA IZAZVANA STREPTOCOCCUS-OM B – Prikaz tri slučaja
NECROTISING FASCIITIS AS RARE ACUTE LIFE THREATENING INFECTION CAUSED BY STREPTOCOCCUS B – Three case reports

Authors

 

Nebojša Marić12, Ljubinko Đenić1, Aleksandar Ristanović1, Nataša Vešović1, Vanja Kostovski1, Dejan Stojković1,Milena Pandrc3, Bojana Miranović1, Vlado Cvijanović1,2
1Klinika za grudnu hirurgiju, Vojnomedicinska akademija, Beograd
2Medicinski fakultet, Vojnomedicinska akademija, Univerzitet odbrane, Beograd
3Klinika za urgentnu medicine, Vojnomedicinska akademija, Beograd


 

• Rad je primljen 07.06.2016. / Prihvaćen 15.06.2016.

 

Correspodernce to:
assist. dr Nebojša Marić,
e-mail: maricvma@gmail.com

 

Abstract

 

Necrotizing fasciitis (NF) is life-threatening, rapidly progressive infection that primarily affects the superficial fascia, with expanding into the subcutaneous adipose tissue, skin, muscles causing their necrosis. Unrecognized or inadequately treated can lead to the development of septic shock, multiple organs dysfunctional syndrome (MODS) and lethal outcome. In this paper we presented three patients treated in the Department of Thoracic Surgery of the MilitaryMedicalAcademy in the last 4 years. Based on clinical and biohumoral parameters and radiological examinations we had the suspicion of NF that is, in the further course, morphological proved.Emergency surgical intervention with administration of antibiotics - cephalosporin of third and fourth generation and supportive therapy is the primary modality NF's treatement. During the therapy, the improvement of general condition, normalization of markers of inflammation with satisfactory local findings were achieved. In one patient the postoperative hyperbaric oxygenation (HBO) and VAC (negative pressure) therapy had influence upon the length of hospitalization. Necrotizing fasciitis is a rare, often unexpected, but very serious infection that can be fatal finished in a very short period of time. In a large percentage of patients, in the initial stage, disease could be misdiagnosed as cellulitis or abscess.It should be noted that the NF should be suspected in any patient presenting with infection, soft tissue swelling and pain that does not correlate with physical findings especially in cases of progression of infection despite the use of broad spectrum antibiotics. Early diagnosis and comprehensive therapeutic approach are crucial to the success of treatment.

 

 

Key words

necrotizing fasciitis, surgery, hyperbaric oxygenation, VAC Therapy

 

 

References

 

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PDF Maric N. et al • MD-Medical Data 2016;8(2) 133-138

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