FASCITIS NECROSANTE

Abstract

Necrotizing fascitis, which has been the object of public attention due to the apparent emergence and the growing virulence of the causative agent, is not a novel disease. However, some cases have been described in which the usual therapy was ineffective and this has contributed to a health care alarm. In the present article, necrotizing fascitis is reviewed and a comment is made on its classification and causative agents, then, the mechanisms underlying the pathogenic power and the worsening of the disease as well as those factors responsible for antibiotic treatment failure - mainly the inoculum effect and resistance - are explained. Finally, the importance of performing a wide surgical debridation of the necrotic tissue is underlined; for the delimitation of this debridation image diagnostic techniques - mainly magnetic nuclear resonance - may be very helpful. The more recommendable antibiotic therapy schedules are also discussed.