The Experts below are selected from a list of 12576 Experts worldwide ranked by ideXlab platform
Morris E Hartstein - One of the best experts on this subject based on the ideXlab platform.
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conservative management of Necrotizing Fasciitis of the eyelids
Ophthalmology, 2002Co-Authors: Jason A Luksich, John B Holds, Morris E HartsteinAbstract:Abstract Objective To describe the management of patients with Necrotizing Fasciitis of the eyelids. Design Retrospective, noncomparative interventional case series. Participants Seven patients with Necrotizing Fasciitis limited to the eyelids. Methods Retrospective review of the charts and photographs of seven patients with Necrotizing Fasciitis limited to the eyelids. Main outcome measures Eyelid function and appearance, mortality, and morbidity. Results Seven of seven patients had good eyelid function and adequate appearance without reconstruction after healing. No deaths occurred. Conclusions Eyelid necrosis due to Necrotizing Fasciitis can be a devastating condition. The morbidity and mortality of selected cases are reduced with prompt and appropriate antimicrobial therapy and nonaggressive debridement of necrotic tissue after autodemarcation of the necrotic zone.
Jason A Luksich - One of the best experts on this subject based on the ideXlab platform.
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conservative management of Necrotizing Fasciitis of the eyelids
Ophthalmology, 2002Co-Authors: Jason A Luksich, John B Holds, Morris E HartsteinAbstract:Abstract Objective To describe the management of patients with Necrotizing Fasciitis of the eyelids. Design Retrospective, noncomparative interventional case series. Participants Seven patients with Necrotizing Fasciitis limited to the eyelids. Methods Retrospective review of the charts and photographs of seven patients with Necrotizing Fasciitis limited to the eyelids. Main outcome measures Eyelid function and appearance, mortality, and morbidity. Results Seven of seven patients had good eyelid function and adequate appearance without reconstruction after healing. No deaths occurred. Conclusions Eyelid necrosis due to Necrotizing Fasciitis can be a devastating condition. The morbidity and mortality of selected cases are reduced with prompt and appropriate antimicrobial therapy and nonaggressive debridement of necrotic tissue after autodemarcation of the necrotic zone.
Mitchell R. Gore - One of the best experts on this subject based on the ideXlab platform.
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Odontogenic Necrotizing Fasciitis: a systematic review of the literature
BMC Ear Nose and Throat Disorders, 2018Co-Authors: Mitchell R. GoreAbstract:Background While odontogenic soft tissue infections of the head and neck are common, progression to Necrotizing Fasciitis is relatively rare. Necrotizing Fasciitis is a potentially life-threatening and rapidly progressive soft tissue infection that can lead to significant skin and soft tissue loss, mediastinitis, vascular thrombosis or rupture, limb loss, organ failure, and death. Methods A PubMed literature search was conducted for case reports and case series on odontogenic Necrotizing Fasciitis. Individual patient data was analyzed and compiled and demographic, treatment, microbiology, and mortality data were extracted. Fisher’s exact test was used to examine the relationship between death from odontogenic Necrotizing Fasciitis and diabetes mellitus (DM) and human immunodeficiency virus (HIV) positivity. Results A total of 58 studies totaling 164 patients were identified. Thirty-three patients had DM and 3 were HIV +. All patients underwent aggressive surgical debridement and treatment with IV antibiotics. Twenty patients were also treated with hyperbaric oxygen. There were 16 deaths reported, for a mortality rate of 9.8%. The mortality rate among patients with DM was 30.3 and 0% among HIV positive patients. There was a statistically significant increase in the mortality rate in DM patients with odontogenic Necrotizing Fasciitis ( p = 0.0001, odds ratio for death 9.1). Conclusions Necrotizing Fasciitis arising from odontogenic infection is a rapidly progressive and life-threatening illness. Prompt recognition of the infection, aggressive and often serial surgical debridement, and aggressive broad-spectrum antibiotics are necessary to prevent serious morbidity and mortality. Patients with diabetes mellitus are at a significantly increased risk of death from odontogenic Necrotizing Fasciitis.
John B Holds - One of the best experts on this subject based on the ideXlab platform.
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conservative management of Necrotizing Fasciitis of the eyelids
Ophthalmology, 2002Co-Authors: Jason A Luksich, John B Holds, Morris E HartsteinAbstract:Abstract Objective To describe the management of patients with Necrotizing Fasciitis of the eyelids. Design Retrospective, noncomparative interventional case series. Participants Seven patients with Necrotizing Fasciitis limited to the eyelids. Methods Retrospective review of the charts and photographs of seven patients with Necrotizing Fasciitis limited to the eyelids. Main outcome measures Eyelid function and appearance, mortality, and morbidity. Results Seven of seven patients had good eyelid function and adequate appearance without reconstruction after healing. No deaths occurred. Conclusions Eyelid necrosis due to Necrotizing Fasciitis can be a devastating condition. The morbidity and mortality of selected cases are reduced with prompt and appropriate antimicrobial therapy and nonaggressive debridement of necrotic tissue after autodemarcation of the necrotic zone.
Cheng-ting Hsiao - One of the best experts on this subject based on the ideXlab platform.
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Prospective Validation of the Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) Score for Necrotizing Fasciitis of the Extremities.
PLOS ONE, 2020Co-Authors: Cheng-ting Hsiao, Chia-peng Chang, Tsung-yu Huang, Yi-chuan Chen, Wen-chih FannAbstract:Objectives The Laboratory Risk Indicator for Necrotizing Fasciitis score was developed as a clinical decision tool for distinguishing Necrotizing Fasciitis from other soft tissue infections. We prospectively evaluated the performance of the Laboratory Risk Indicator for Necrotizing Fasciitis score for the diagnosis of patients with Necrotizing Fasciitis in the extremities. Methods We conducted a prospective and observational cohort study of emergency department patients with Necrotizing Fasciitis or severe cellulitis in the extremities between April 2015 and December 2016. The Laboratory Risk Indicator for Necrotizing Fasciitis score was calculated for every enrolled patient. The sensitivity, specificity, positive predictive value, and negative predictive value of cut-off scores of 6 and 8 were evaluated. The accuracy of the Laboratory Risk Indicator for Necrotizing Fasciitis score was expressed as the area under the receiver operating characteristic curve. Results A total of 106 patients with Necrotizing Fasciitis and 825 patients with cellulitis were included. With an Laboratory Risk Indicator for Necrotizing Fasciitis cut-off score ≥6, the sensitivity was 43% (95% confidence interval 34% to 53%), specificity was 83% (95% confidence interval 80% to 86%), positive predictive value was 25% (95% confidence interval 20% to 30%), and negative predictive value was 92% (95% confidence interval 91% to 93%); with an Laboratory Risk Indicator for Necrotizing Fasciitis cut-off score ≥8, the sensitivity was 27% (95% confidence interval 19% to 37%), specificity was 93% (95% confidence interval 91% to 94%), positive predictive value was 33% (95% confidence interval 25% to 42%), and negative predictive value was 91% (95% confidence interval 90% to 92%). The area under the receiver operating characteristic curve for accuracy of the Laboratory Risk Indicator for Necrotizing Fasciitis score was 0.696 (95% CI 0.640 to 0.751). Conclusion The Laboratory Risk Indicator for Necrotizing Fasciitis score may not be an accurate tool for Necrotizing Fasciitis risk stratification and differentiation between severe cellulitis and Necrotizing Fasciitis in the emergency department setting based on our study.
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Predictors of mortality in patients with Necrotizing Fasciitis.
The American Journal of Emergency Medicine, 2008Co-Authors: Cheng-ting Hsiao, Hsu-huei Weng, Yao-dong Yuan, Chih-tsung Chen, I-chuan ChenAbstract:Abstract Background Necrotizing Fasciitis is an uncommon and life-threatening soft tissue infection with high mortality. Though early aggressive surgical intervention is important for improving survival, the impact of mortality from different microorganisms remains uncertain. Our study aims to identify the association of mortality and different microorganisms, and the positive and negative predictors of mortality in patients with Necrotizing Fasciitis. Methods This retrospective cohort study enrolled patients admitted via the emergency department (ED) with discharged diagnosis of Necrotizing Fasciitis (International Classification of Diseases, Ninth Revision, code 72886). Multivariate logistic regression analysis was used to identify microbiological, clinical, and biochemical variables independently associated with the mortality of Necrotizing Fasciitis. Results Multivariate logistic regression analysis showed that Vibrio infection, Aeromonas infection, hypotension, malignancy, and band form 10% or greater were significantly associated with increase of mortality (P Conclusion Aeromonas infection, Vibrio infection, cancer, hypotension, and band form white blood cell count greater than 10% are independent positive predictors of mortality in patients with Necrotizing Fasciitis. Streptococcal and staphylococcal infections, in contrast, are not predictors of mortality. The presence of hemorrhagic bullae is an independent negative predictor of mortality. Further study should focus on the accuracy of these factors.
