Zil-E-Ali Ahsan, Naqvi Syeda, Tariq Mariam
General Surgery, Pak Red Crescent Hospital.
Jinnah Postgraduate Medical Centre, Jinnah Sindh Medical University (SMC).
Cureus. 2017 Jul 8;9(7):e1446. doi: 10.7759/cureus.1446.
Necrotizing fasciitis (NF) is a rare but life-threatening medical and surgical emergency. It is characterized by necrosis of the soft tissue leaving the overlying tissue unaffected, which delays the diagnosis and treatment. Delay in recognition of the severity of necrotizing fasciitis might lead to serious morbidity and mortality. Diagnosis of NF relies on strong clinical judgment, predictable by severe pain, erythema, and a presence of air under the skin, but all of them are not always present. Management of NF is prompt surgical intervention and antimicrobial therapy. The effectiveness depends on the timely diagnosis of NF because it rapidly spreads and may cause irreversible damage. Various investigations for necrotizing fasciitis have been proposed. However, misdiagnosis is not infrequent and more work is needed to identify the different presentations across the spectrum. We consider changing it to discuss the role of procalcitonin in the diagnosis of necrotizing fasciitis.There is scarce literature about its clinical role in necrotizing fasciitis although it has evolved not only as a prognostic marker but also as a way of differentiating between cellulitis and necrotizing fasciitis. It can also predict the future consequences of septic shock.
坏死性筋膜炎（NF）是一种罕见但危及生命的内科和外科急症。其特征是软组织坏死而覆盖其上的组织未受影响，这会延误诊断和治疗。对坏死性筋膜炎严重程度认识的延迟可能导致严重的发病率和死亡率。NF的诊断依赖于强有力的临床判断，其可表现为剧痛、红斑以及皮下气肿，但这些表现并非总是全部出现。NF的治疗是迅速进行手术干预和抗菌治疗。其有效性取决于NF的及时诊断，因为它会迅速扩散并可能造成不可逆的损害。已提出了多种针对坏死性筋膜炎的检查方法。然而，误诊并不罕见，还需要开展更多工作来识别该疾病不同阶段的表现。我们考虑将其改为讨论降钙素原在坏死性筋膜炎诊断中的作用。尽管降钙素原不仅已发展成为一种预后标志物，还成为区分蜂窝织炎和坏死性筋膜炎的一种方法，但其在坏死性筋膜炎中临床作用的相关文献却很匮乏。它还能预测感染性休克的未来后果。
