Risk factors
Infections in NF usually take place in a hypoxic environment with decreased function of polymorphonuclear leukocytes. Hence patients with NF usually have some predisposition to infection. Some known risk factors of NF include: (1)
- diabetes and other chronic medical diseases
- immunosuppressive drugs
- malnutrition
- advanced age e.g. - age >60 years
- IV drug use
- peripheral vascular disease
- obesity
- underlying malignancy
Clinicians should obtain specific history form patient to gather information about any precipitating events which might have caused NF. e.g. -
- traumatic event - surgery, IV drug use, penetrating injury
- non traumatic - soft tissue infections, burns, childbirth etc
It should be noted that around 25% of cases occur in patients without comorbidity or precedent trauma (2).
Reference:
- Pasternack MS, Swartz MN. Cellulitis, necrotizing fasciitis, and subcutaneous tissue infections. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett’s principles and practice of infectious diseases. Philadelphia, PA: Elsevier; 2015:1194-215.
- Sultan HY, Boyle AA, Sheppard N.Necrotising fasciitis. BMJ. 2012;345:e4274.
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