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Description

Necrotizing fasciitis can be classified by the bacterial isolates. The type of isolate often correlates with the clinical history and course.


Bacterial Isolate

Type

polymicrobic (with synergistic action)

I

Streptococcus pyogenes (Group A beta-hemolytic)

II

Vibrio species

III

 

Features of Type I:

(1) underlying comorbidity usually present

(2) often preceded by a cellulitis

(3) may follow a fulminant course, often with sepsis and/or multi-organ failure

 

Features of Type II:

(1) underlying comorbidity often absent

(2) may be more frequently seen in pediatric patients

(3) may follow a seemingly minor abrasion or injury

(4) usually evolves over days

 

Features of Type III:

(1) underlying comorbidity usually present

(2) history of exposure to salt water or seafood

 

where:

• The combination of Streptococcus pyogenes and Staphylococcus aureus may share features of Type I and II.

 


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