DR Medhat MRCP

Necrotizing fasciitis :
- Is a medical emergency that is difficult to recognise in the early stages.
- It can be classified according to the causative organism:
Type 1 : is caused by mixed anaerobes and aerobes (often occurs postsurgery
in diabetics).
Type 2 : is caused by Streptococcus pyogenes
- Features
1) Acute onset.
2) Painful, erythematous lesion develop.
3) Extremely tender over infected tissue
- Management
Urgent surgical debridement
IV antibiotics
B) Staphylococci
Coagulase +ve
Coagulase -ve
Staph. Aureus (SA)
Staph. Epidermidis
1. Methicillin sensitive. ( most common cause of I.V line sepsis)
2. Methicillin resistant (MRSA)
Staphylococcal toxic shock syndrome
- Describes a severe systemic reaction to staphylococcal exotoxins.
الفوط الصحية - Source is infected tampons
- Diagnostic criteria :
1) Fever: temperature > 38.9ºc
2) Hypotension: systolic blood pressure < 90 mmHg.
3) Diffuse erythematous rash
4) Desquamation of rash, especially of the palms and soles.
5) Involvement of ≥3 organ systems: e.g.
o GIT (diarrhoea and vomiting)
o Mucous membrane erythema .
o Renal failure
o Hepatitis
o Blood : Thrombocytopenia
o CNS involvement (e.g.Confusion)
- TTT of staph. Toxic syndrome : according to type of staph in C/S.
Methecillin sensitive SA : Cloxacillin + Clindamycin.
MRSA : Vancomycin or Teicoplanin + Clindamycin.
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