Necrotising fasciitis: clinical features in patients with liver cirrhosis

• Published in: British journal of plastic surgery 2005-07, Vol.58 (5), p.702-707
• Main Authors: Cheng, Nai-Chen, Tai, Hao-Chi, Tang, Yueh-Bih, Chang, Shan-Chwen, Wang, Jann-Tay
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Bacterial diseases; Bacterial diseases of the nervous system. Bacterial myositis; Biological and medical sciences; Diabetes Complications; Diabetes mellitus; Fasciitis, Necrotizing - etiology; Fasciitis, Necrotizing - microbiology; Female; Gastroenterology. Liver. Pancreas. Abdomen; Human bacterial diseases; Humans; Infectious diseases; Leg; Liver cirrhosis; Liver Cirrhosis - complications; Liver. Biliary tract. Portal circulation. Exocrine pancreas; Male; Medical sciences; Middle Aged; Necrotising fasciitis; Other diseases. Semiology; Prognosis; Retrospective Studies; Risk Factors; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
• ISSN: 0007-1226; 1465-3087
• DOI: 10.1016/j.bjps.2005.01.019

Necrotising fasciitis is a fulminant and life-threatening infection. It is associated with a high mortality rate and is often seen in the aged and immunocompromised patients. Liver cirrhosis is regarded as a risk factor of necrotising fasciitis. From January 1995 to December 2003, 17 cirrhotic patients who had been admitted to our hospital for necrotising fasciitis were identified. The infection all developed in the lower extremities. Only six patients survived, and the overall case fatality rate was 64.7%. The cases were divided into two groups: survivors and nonsurvivors. Comparisons were made on age, gender, presenting symptoms, underlying medical diseases, laboratory data and clinical course. Underlying diabetes mellitus and grade C liver cirrhosis were the only statistically significant factors that led to poor prognosis ( p