[Syndrome of infectious-toxic shock in the structure of patients with necrotizing fasciitis].

Among 28 patients with necrotizing fasciitis 18 patients had the syndrome of infectious-toxic shock with clinically severe manifestations. Nine of them had the disease with most serious (lightening-like) clinical forms of severe sepsis that led to lethal outcomes within 1-3 days. This form is referred to as an irreversible septic shock and genetically is due to two factors: 1. Type of the pathogen (Streptococcus pyogenes) whose toxin is responsible for the septic shock syndrome. 2. Spacious zone of the superficial fascia necrosis, a massive source of endotoxemia resulting from generalized thrombosis of the microcirculation bed of the fascial structures. There is no alternative to the method of treatment of patients with necrotizing fasciitis but urgent (immediately after the diagnosis) and aggressive in volume and character operation as well as an adequate resuscitation management and antibiotic therapy.