Which histologic findings are characteristic of necrotizing fasciitis?

Updated: Oct 17, 2018
  • Author: Steven A Schulz, MD; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

Sections from necrotizing fasciitis tissue show superficial fascial necrosis with blood vessels occluded by thrombi. A dense infiltration of neutrophils may be observed in deeper parts of the subcutaneous tissue and fascia. Subcutaneous fat necrosis and vasculitis are also evident. Eccrine glands and ducts may be necrotic. Alcian blue or periodic acid-Schiff staining with diastase may show clusters of bacteria and fungi (see the image below).

Photomicrograph of Fournier gangrene (necrotizing Photomicrograph of Fournier gangrene (necrotizing fasciitis), oil immersion at 1000X magnification. Note the acute inflammatory cells in the necrotic tissue. Bacteria are located in the haziness of their cytoplasm. Courtesy of Billie Fife, MD, and Thomas A. Santora, MD.

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