@2024 Afarand., IRAN
ISSN: 2383-3483 Journal of Police Medicine 2019;8(1):47-51
ISSN: 2383-3483 Journal of Police Medicine 2019;8(1):47-51
Necrotizing Fasciitis in Soldiers; Two Cases Report
ARTICLE INFO
Article Type
Original ResearchAuthors
Ghaffari M. (1)Shahabinejad M. (*)
Shahabinejad N. (1)
(*) Applied Research Center, Behdad Deputy of IRI Police Force, Tehran, Iran
(1) Sayed-al-Shohada Hospital, Kerman, Iran
Correspondence
Address: Applied Research Center of IRI Police Force, Vali-e-Asr Hospital, Up the Vanak Square, Tehran, IranPhone: -
Fax: -
mostafa.sh.n2212@gmail.com
Article History
Received: September 5, 2018Accepted: November 21, 2018
ePublished: December 31, 2019
ABSTRACT
Aims
Necrotizing Fasciitis is a rare but life-threatening infection which engage most soft tissues and muscles in the lower limbs. The purpose of this study was to report the incidence of necrotizing fasciitis in soldiers with the aim of developing preventive strategies for injury.
Patient & Methods Two soldiers suffered from the lower extremity pain at different times during military service in the garrison. In the initial visits to the treatment center, they were treated outpatiently, but with exacerbation of symptoms and recurrences, they were hospitalized for diagnosis of necrotizing fasciitis. Both patients had antibiotic treatment at the same time after fasciotomy and several occasions of necrotic tissue debridement. One of the patients died and the other improved.
Conclusion Because muscle sprains and muscular injuries are abundant in soldiers, there is a possibility of Streptococcus group A (GAS) transmitted by the blood from the throat to the blunt trauma site or the muscle strain and pressure on the muscle.
Patient & Methods Two soldiers suffered from the lower extremity pain at different times during military service in the garrison. In the initial visits to the treatment center, they were treated outpatiently, but with exacerbation of symptoms and recurrences, they were hospitalized for diagnosis of necrotizing fasciitis. Both patients had antibiotic treatment at the same time after fasciotomy and several occasions of necrotic tissue debridement. One of the patients died and the other improved.
Conclusion Because muscle sprains and muscular injuries are abundant in soldiers, there is a possibility of Streptococcus group A (GAS) transmitted by the blood from the throat to the blunt trauma site or the muscle strain and pressure on the muscle.
Keywords:
Necrotizing Fasciitis,
Soldiers,
Streptococcus Group A,
Single Microbial Necrotizing Fasciitis,
CITATION LINKS
[1]Naqvi G, Malik S, Jan W. Necrotizing fasciitis of the lower extremity: A case report and current concept of diagnosis and management. Scand J Trauma Resusc Emerg Med. 2009;17(1):28.
[2]Malhotra S, Kansal A, Datey S, Rao H. Study of the clinical profiles of necrotising fasciitis. Hypertension. 2017;6(60):4388-91.
[3]Fumis MA, Bidabehere MB, Moyano Y, Sardoy A, Gubiani ML, Boldrini MP, et al. Necrotizing fasciitis caused by Streptococcus pyogenes: A case report. Revista de la Facultad de Ciencias Medicas (Cordoba, Argentina). 2017;74(3):281-7. [Spanish]
[4] Cohen J, Powderly WG, Opal SM. Necrotizing fasciitis, GAS gangrene myositis and myonecrosis. In: Cohen J, editor. Infectious Diseases. 1st edition. USA: Elsevier; 2016. pp. 95-103.
[5]Jabbour G, El-Menyar A, Peralta R, Shaikh N, Abdelrahman H, Mudali IN, et al. Pattern and predictors of mortality in necrotizing fasciitis patients in a single tertiary hospital. World J Emerge Surg. 2016;11(1):40.
[6]Mandell G, Bennett J, Dolin R. Necrotizing fasciitis. In: Krehling H, editor. Principles and practice of infectious disease. 1st editon. Philadelphia: Churchill Livingstone Elsevier; 2010. pp. 1290-312.
[7]Khamnuan P, Chongruksut W, Jearwattanakanok K, Patumanond J, Yodluangfun S, Tantraworasin A. Necrotizing fasciitis: Risk factors of mortality. Risk Manag Healthc policy. 2015;8:1-7.
[8]Arif N, Yousfi S, Vinnard C. Deaths from necrotizing fasciitis in the United States, 2003-2013. Epidemiol Infect. 2016;144(6):1338-44.
[9]Cai Y, Gan Y, Yu C, Tang J, Sun Y. A successful treatment of necrotizing fasciitis following the surgery of distal radius plate removal: A case report and literature review. Medicine. 2018;97(15):e0305.
[10]Harbrecht BG, Nash NA. Necrotizing soft tissue infections: A review. Surg Infect. 2016;17(5):503-9.
[11] Goh T, Goh L, Ang CH, Wong CH. Early diagnosis of necrotizing fasciitis. Br J Surg. 2014;101(1):e119-25.
[12]Zhao JC, Zhang BR, Shi K, Zhang X, Xie CH, Wang J, et al. Necrotizing soft tissue infection: clinical characteristics and outcomes at a reconstructive center in Jilin Province. BMC Infect Dis. 2017;17(1):792.
[13] El-Menyar A, Asim M, Mudali IN, Mekkodathil A, Latifi R, Al-Thani H. The laboratory risk indicator for necrotizing fasciitis (LRINEC) scoring: The diagnostic and potential prognostic role. Scand J Trauma Resus Emerg Med. 2017;25(1):28-37.
[14]Misiakos EP, Bagias G, Patapis P, Sotiropoulos D, Kanavidis P, Machairas A. Current concepts in the management of necrotizing fasciitis. Front Surg. 2014;1:36-46.
[15]Amanollahi A, Hollisaz MT, Askari K, Saburi A. Efficacy of physiotherapy compared to steroid injection for adductor muscle strain. India J Pain. 2015;29(2):96-9.
[16]Jennings BM, Yoder LH, Heiner SL, Loan LA, Bingham MO. Soldiers with musculoskeletal injuries. J Nurs Scholarsh. 2008;40(3):268-74.
[17]Andersen KA, Grimshaw PN, Kelso RM, Bentley DJ. Musculoskeletal lower limb injury risk in army populations. Sports Med Open. 2016;2(1):22.
[18]Webber BJ, Kieffer JW, White BK, Hawksworth AW, Graf PC, Yun HC. Chemoprophylaxis against group A streptococcus during military training. Prev Med. 2018;118:142-9.
[19]Chang C-P, Hsiao C-T, Lin C-N, Fann W-C. Risk factors for mortality in the late amputation of necrotizing fasciitis: a retrospective study. World J Emerg Surg. 2018;13(1):45.
[20]Khamnuan P, Chongruksut W, Jearwattanakanok K, Patumanond J, Tantraworasin A. Necrotizing fasciitis: Epidemiology and clinical predictors for amputation. Int J Gen Med. 2015;8:195-202.
[21]Erichsen Andersson A, Egerod I, Knudsen VE, Fagerdahl AM. Signs, symptoms and diagnosis of necrotizing fasciitis experienced by survivors and family: A qualitative Nordic multi-center study. BMC Infect Dis. 2018;18:429.
[22]Chan JJ, Sheth SK. A rare and fatal cause of right iliac fossa pain—When retroperitoneal necrotizing fasciitis masquerades as acute appendicitis: A case report and review of recent reported cases. Hong Kong J Emerg Med. 2018;25(6):366-70.
[23]Hammond-Collins K, Strauss B, Barnes K, Demczuk W, Domingo MC, Lamontagne MC, et al. Group A streptococcus outbreak in a canadian armed forces training facility. Mil Med. 2018. doi: 10.1093/milmed/usy198.
[2]Malhotra S, Kansal A, Datey S, Rao H. Study of the clinical profiles of necrotising fasciitis. Hypertension. 2017;6(60):4388-91.
[3]Fumis MA, Bidabehere MB, Moyano Y, Sardoy A, Gubiani ML, Boldrini MP, et al. Necrotizing fasciitis caused by Streptococcus pyogenes: A case report. Revista de la Facultad de Ciencias Medicas (Cordoba, Argentina). 2017;74(3):281-7. [Spanish]
[4] Cohen J, Powderly WG, Opal SM. Necrotizing fasciitis, GAS gangrene myositis and myonecrosis. In: Cohen J, editor. Infectious Diseases. 1st edition. USA: Elsevier; 2016. pp. 95-103.
[5]Jabbour G, El-Menyar A, Peralta R, Shaikh N, Abdelrahman H, Mudali IN, et al. Pattern and predictors of mortality in necrotizing fasciitis patients in a single tertiary hospital. World J Emerge Surg. 2016;11(1):40.
[6]Mandell G, Bennett J, Dolin R. Necrotizing fasciitis. In: Krehling H, editor. Principles and practice of infectious disease. 1st editon. Philadelphia: Churchill Livingstone Elsevier; 2010. pp. 1290-312.
[7]Khamnuan P, Chongruksut W, Jearwattanakanok K, Patumanond J, Yodluangfun S, Tantraworasin A. Necrotizing fasciitis: Risk factors of mortality. Risk Manag Healthc policy. 2015;8:1-7.
[8]Arif N, Yousfi S, Vinnard C. Deaths from necrotizing fasciitis in the United States, 2003-2013. Epidemiol Infect. 2016;144(6):1338-44.
[9]Cai Y, Gan Y, Yu C, Tang J, Sun Y. A successful treatment of necrotizing fasciitis following the surgery of distal radius plate removal: A case report and literature review. Medicine. 2018;97(15):e0305.
[10]Harbrecht BG, Nash NA. Necrotizing soft tissue infections: A review. Surg Infect. 2016;17(5):503-9.
[11] Goh T, Goh L, Ang CH, Wong CH. Early diagnosis of necrotizing fasciitis. Br J Surg. 2014;101(1):e119-25.
[12]Zhao JC, Zhang BR, Shi K, Zhang X, Xie CH, Wang J, et al. Necrotizing soft tissue infection: clinical characteristics and outcomes at a reconstructive center in Jilin Province. BMC Infect Dis. 2017;17(1):792.
[13] El-Menyar A, Asim M, Mudali IN, Mekkodathil A, Latifi R, Al-Thani H. The laboratory risk indicator for necrotizing fasciitis (LRINEC) scoring: The diagnostic and potential prognostic role. Scand J Trauma Resus Emerg Med. 2017;25(1):28-37.
[14]Misiakos EP, Bagias G, Patapis P, Sotiropoulos D, Kanavidis P, Machairas A. Current concepts in the management of necrotizing fasciitis. Front Surg. 2014;1:36-46.
[15]Amanollahi A, Hollisaz MT, Askari K, Saburi A. Efficacy of physiotherapy compared to steroid injection for adductor muscle strain. India J Pain. 2015;29(2):96-9.
[16]Jennings BM, Yoder LH, Heiner SL, Loan LA, Bingham MO. Soldiers with musculoskeletal injuries. J Nurs Scholarsh. 2008;40(3):268-74.
[17]Andersen KA, Grimshaw PN, Kelso RM, Bentley DJ. Musculoskeletal lower limb injury risk in army populations. Sports Med Open. 2016;2(1):22.
[18]Webber BJ, Kieffer JW, White BK, Hawksworth AW, Graf PC, Yun HC. Chemoprophylaxis against group A streptococcus during military training. Prev Med. 2018;118:142-9.
[19]Chang C-P, Hsiao C-T, Lin C-N, Fann W-C. Risk factors for mortality in the late amputation of necrotizing fasciitis: a retrospective study. World J Emerg Surg. 2018;13(1):45.
[20]Khamnuan P, Chongruksut W, Jearwattanakanok K, Patumanond J, Tantraworasin A. Necrotizing fasciitis: Epidemiology and clinical predictors for amputation. Int J Gen Med. 2015;8:195-202.
[21]Erichsen Andersson A, Egerod I, Knudsen VE, Fagerdahl AM. Signs, symptoms and diagnosis of necrotizing fasciitis experienced by survivors and family: A qualitative Nordic multi-center study. BMC Infect Dis. 2018;18:429.
[22]Chan JJ, Sheth SK. A rare and fatal cause of right iliac fossa pain—When retroperitoneal necrotizing fasciitis masquerades as acute appendicitis: A case report and review of recent reported cases. Hong Kong J Emerg Med. 2018;25(6):366-70.
[23]Hammond-Collins K, Strauss B, Barnes K, Demczuk W, Domingo MC, Lamontagne MC, et al. Group A streptococcus outbreak in a canadian armed forces training facility. Mil Med. 2018. doi: 10.1093/milmed/usy198.