Necrotizing Fasciitis

Jennifer T. Trent, MD, Robert S. Kirsner, MD


Wounds. 2002;14(8) 

In This Article

Types of NF

Several classification systems, not mutually exclusive, exist to categorize NF. NF can be categorized based on the culprit microorganisms cultured from the wounds ( Table 2 ).[1,6,9,20,21] Two types exist. Type 1 NF is a polymicrobial infection consisting of infection with aerobic and anaerobic bacteria, such as Clostridium and Bacteroides species, which work synergistically in the progression of NF. Type 2 NF consists of group A Streptococcus (S. pyogenes) with or without a coexisting Staphylococcal infection.

Also, NF is divided by the rapidity of presentation. In this schema, NF is divided into three groups (fulminant, acute, subacute) based on the initial clinical presentation of the patient, including length of infection and extent of the disease.[22] Patients with fulminant disease present with rapid disease progression and shock. These patients will report having symptoms for only several hours with few blisters on a small area of skin. Patients with acute disease suffer from symptoms for several days often with large areas of their skin involved. Finally, patients with subacute disease may describe having worsening symptoms over the course of several weeks with only localized skin involvement.