Microbiology-necrotizing soft-tissue infections

Necrotizing soft tissue infections = NSTI

Type I:

• polymicrobial (mixed aerobes & anaerobes), typically in older Pts w/ above RFs. Fournier’s gangrene involves genitalia and/or perineum
  • 第一型是多菌種，老人家、有很多Risk factor
  • 如果有爛到會陰部，叫Fournier’s gangrene
• Head and neck NSTI evolve from oral flora including anaerobes
  • 同頸部會包含一些oral flora and anaerobes

Type II:

• monomicrobial, usually group A strep,
• less likely Staph, Vibrio, Aero.;
• a/w TSS: Streptococcal toxic shock syndrome

Clostridial myonecrosis (gas gangrene):

• C. perfringens; C. septicum (large Gram ⊕ rods w/ blunt ends on Gram stain). A/w traumatic wounds that create an anaerobic environment ideal for Clostridia.
  • 梭菌性肌壞死（氣性壞疽）