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Reliable, easy-to-read patient information on common medical conditions — written in plain language, free of jargon, and grounded in current evidence. Browse the most frequent diagnoses, understand what they mean for everyday life, and learn which steps and questions help you have a focused conversation with your doctor.

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Necrotizing fasciitis classification

Introduction

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		 ● Mixed aerobes and anaerobes
● Often bowel flora-derived
Type 2 (20% to 30% cases)
Monomicrobial		 ● Beta-Hemolytic Streptococci group A (Streptococcus pyogenes)
● with/without Staphylococcus aureus
● Skin or throat derived
Type 3 (common in Asia)
Gram negative monomicrobial NF (including marine related organisms)		 ● Vibrio spp mainly
Type 4
Fungal		 ● Candida (Immunocompromised patients)
● Zygomycetes (Immunocompetent patients)
  • Based on anatomic location, necrotizing fasciitis may be classified into:[2]
  • Based on severity of disease, necrotizing fasciitis is classified into:[11]
  • Hyperacute
  • Sub-acute
References

References

  1. ↑ ICD-10 version:2016. http://apps.who.int/classifications/icd10/browse/2016/en#/M72.6 2016 Accessed on August 25,2016
  2. ↑ 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): 560–6. doi:10.1097/TA.0b013e318232a6b3. PMID 22491537.
  3. ↑ Morgan MS (2010). “Diagnosis and management of necrotising fasciitis: a multiparametric approach”. J Hosp Infect. 75 (4): 249–57. doi:10.1016/j.jhin.2010.01.028. PMID 20542593.
  4. ↑ Giuliano A, Lewis F, Hadley K, Blaisdell FW (1977). “Bacteriology of necrotizing fasciitis”. Am J Surg. 134 (1): 52–7. PMID 327844.
  5. ↑ 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): 278–81. doi:10.1097/01.CCM.0000104920.01254.82. PMID 14707592.
  6. ↑ 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): 459–67. doi:10.1089/sur.2007.028. PMID 18687029.
  7. ↑ 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): 1221–6. doi:10.1038/modpathol.3800639. PMID 16741524.
  8. ↑ Quirk WF, Sternbach G (1996). “Joseph Jones: infection with flesh eating bacteria”. J Emerg Med. 14 (6): 747–53. PMID 8969999.
  9. ↑ Kihiczak GG, Schwartz RA, Kapila R (2006). “Necrotizing fasciitis: a deadly infection”. J Eur Acad Dermatol Venereol. 20 (4): 365–9. doi:10.1111/j.1468-3083.2006.01487.x. PMID 16643131.
  10. ↑ Wasson J, Hopkins C, Bowdler D (2006). “Did Ludwig’s angina kill Ludwig?”. J Laryngol Otol. 120 (5): 363–5. doi:10.1017/S0022215106000806. PMID 16696873.
  11. ↑ Wong CH, Wang YS (2005). “The diagnosis of necrotizing fasciitis”. Curr Opin Infect Dis. 18 (2): 101–6. PMID 15735411.

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Yamuna Kondapally, M.B.B.S[2]