Necrotizing fasciitis classification
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Yamuna Kondapally, M.B.B.S[2]
Overview
Overview
Necrotizing fasciitis may be classified according to International Classification of Diseases-10 (ICD-10) into M72.6 Necrotizing fasciitis.[1] Based on microbiological findings, necrotizing fasciitis may be classified into four types: Type I, Type II, Type III, and Type IV. Necrotizing fasciitis is further classified based on anatomic location and severity of symptoms.[2]
Classification
Classification
Based on microbiological findings, necrotizing fasciitis may be classified into four types.[3][4][5][6][7][8][9]
| Type | Organism |
|---|---|
| Type 1 (70%-80% cases) Polymicrobial/Synergistic |
β Mixed aerobes and anaerobes β Often bowel flora-derived |
| Type 2 (20% to 30% cases) Monomicrobial |
β Beta-Hemolytic Streptococci group A (Streptococcus pyogenes) β with/without Staphylococcus aureus β Skin or throat derived |
| Type 3 (common in Asia) Gram negative monomicrobial NF (including marine related organisms) |
β Vibrio spp mainly |
| Type 4 Fungal |
β Candida (Immunocompromised patients) β Zygomycetes (Immunocompetent patients) |
- Based on anatomic location, necrotizing fasciitis may be classified into:[2]
- Fournier’s gangrene (necrotizing fasciitis of perineum)
- Craniofascial necrotizing fasciitis
- Cervical fasciitis
- Ludwig’s angina (submandibular and sublingual spaces)[10]
- Based on severity of disease, necrotizing fasciitis is classified into:[11]
- Hyperacute
- Sub-acute
References
References
- β ICD-10 version:2016. http://apps.who.int/classifications/icd10/browse/2016/en#/M72.6 2016 Accessed on August 25,2016
- β 2.0 2.1 Lancerotto L, Tocco I, Salmaso R, Vindigni V, Bassetto F (2012). “Necrotizing fasciitis: classification, diagnosis, and management”. J Trauma Acute Care Surg. 72 (3): 560β6. doi:10.1097/TA.0b013e318232a6b3. PMIDΒ 22491537.
- β Morgan MS (2010). “Diagnosis and management of necrotising fasciitis: a multiparametric approach”. J Hosp Infect. 75 (4): 249β57. doi:10.1016/j.jhin.2010.01.028. PMIDΒ 20542593.
- β Giuliano A, Lewis F, Hadley K, Blaisdell FW (1977). “Bacteriology of necrotizing fasciitis”. Am J Surg. 134 (1): 52β7. PMIDΒ 327844.
- β Goodell KH, Jordan MR, Graham R, Cassidy C, Nasraway SA (2004). “Rapidly advancing necrotizing fasciitis caused by Photobacterium (Vibrio) damsela: a hyperaggressive variant”. Crit Care Med. 32 (1): 278β81. doi:10.1097/01.CCM.0000104920.01254.82. PMIDΒ 14707592.
- β Monaghan SF, Anjaria D, Mohr A, Livingston DH (2008). “Necrotizing fasciitis and sepsis caused by Aeromonas hydrophila after crush injury of the lower extremity”. Surg Infect (Larchmt). 9 (4): 459β67. doi:10.1089/sur.2007.028. PMIDΒ 18687029.
- β Jain D, Kumar Y, Vasishta RK, Rajesh L, Pattari SK, Chakrabarti A (2006). “Zygomycotic necrotizing fasciitis in immunocompetent patients: a series of 18 cases”. Mod Pathol. 19 (9): 1221β6. doi:10.1038/modpathol.3800639. PMIDΒ 16741524.
- β Quirk WF, Sternbach G (1996). “Joseph Jones: infection with flesh eating bacteria”. J Emerg Med. 14 (6): 747β53. PMIDΒ 8969999.
- β Kihiczak GG, Schwartz RA, Kapila R (2006). “Necrotizing fasciitis: a deadly infection”. J Eur Acad Dermatol Venereol. 20 (4): 365β9. doi:10.1111/j.1468-3083.2006.01487.x. PMIDΒ 16643131.
- β Wasson J, Hopkins C, Bowdler D (2006). “Did Ludwig’s angina kill Ludwig?”. J Laryngol Otol. 120 (5): 363β5. doi:10.1017/S0022215106000806. PMIDΒ 16696873.
- β Wong CH, Wang YS (2005). “The diagnosis of necrotizing fasciitis”. Curr Opin Infect Dis. 18 (2): 101β6. PMIDΒ 15735411.
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