Differences in the clinical presentation of necrotizing fasciitis depending on the causative pathogen

• Published in: Journal of dermatology 2024-12, Vol.51 (12), p.1698-1701
• Main Authors: Kato, Hiroshi, Kawaguchi, Yohei, Saito, Kenta, Hamamoto, Shuzo, Nakamura, Ryota, Ohashi, Kazuki, Kondo, Shuhei, Nakamura, Atsushi, Morita, Akimichi
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Anaerobic bacteria; Anti-Bacterial Agents - therapeutic use; Bacteremia; Bacteremia - diagnosis; Bacteremia - drug therapy; Bacteremia - microbiology; Bacteremia - mortality; Bacteria; Coinfection - diagnosis; Coinfection - microbiology; Coinfection - mortality; Fasciitis, Necrotizing - diagnosis; Fasciitis, Necrotizing - microbiology; Fasciitis, Necrotizing - mortality; Fasciitis, Necrotizing - therapy; Female; Fournier's gangrene; group a beta‐hemolytic streptococcus; group G beta‐hemolytic Streptococcus; Humans; Infections; Male; Medical prognosis; Middle Aged; Mixed infection; Necrotizing fasciitis; Pathogens; Patients; Retrospective Studies; Staphylococcal Infections - diagnosis; Staphylococcal Infections - microbiology; Staphylococcal Infections - mortality; Staphylococcus aureus; Staphylococcus aureus - isolation & purification; Streptococcal Infections - diagnosis; Streptococcal Infections - drug therapy; Streptococcal Infections - microbiology; Streptococcal Infections - mortality; Streptococcus; Streptococcus - isolation & purification; Streptococcus infections; Streptococcus pyogenes - isolation & purification
• ISSN: 0385-2407; 1346-8138; 1346-8138
• DOI: 10.1111/1346-8138.17325

Necrotizing fasciitis is a fatal, soft tissue infection of the skin that requires prompt treatment. Historically, most cases have been attributed to group A beta‐hemolytic Streptococcus infection. However, in recent years, other bacteria have been identified as causing necrotizing fasciitis. In the current study, we analyzed cases of necrotizing fasciitis and examined the significant differences in symptoms caused by pathogenic bacteria. We included 79 patients (43 males and 36 females, mean age 65.4 years) diagnosed with necrotizing fasciitis who visited our hospital between April 2004 and July 2023. The patients were classified into five groups based on the identified pathogen: group A beta‐hemolytic Streptococcus; group B beta‐hemolytic streptococcus; group G beta‐hemolytic Streptococcus; mixed infection, including anaerobic bacteria; and Staphylococcus (S) aureus. The clinical characteristics of patients, including treatment duration and laboratory values, were analyzed. Group G beta‐hemolytic Streptococcus was more common in older patients (Bonferroni method, p