What causes necrotizing fasciitis in omphalitis?

Updated: May 20, 2019
  • Author: Patrick G Gallagher, MD; Chief Editor: Santina A Zanelli, MD  more...
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Answer

This is a florid bacterial infection of the skin, subcutaneous fat, and superficial and deep fascia that complicates 8%-16% of cases of neonatal omphalitis. [38, 39, 40, 41, 42, 43, 44] It is characterized by rapidly spreading infection and severe systemic toxicity. Necrotizing fasciitis typically involves the abdominal wall but may also involve the scrotum or penis.

Necrotizing soft-tissue infections are caused by production of factors (by single or multiple organisms) that lead directly to tissue cell death, enzymatic destruction of supporting connective tissue, and destruction of host humoral and cellular immune responses to infecting organisms.

Certain organisms are well known to invade tissue and proliferate in necrotic areas. Group A Streptococcus, S aureus, and Clostridium species may elaborate extracellular enzymes and toxins that can damage tissue, may facilitate movement of organisms through soft-tissue planes, and may limit host defenses and penetration of systemic antimicrobial agents. [3]


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