Necrotizing soft-tissue infections

Necrotizing soft tissue infections (NSTIs) are relatively uncommon disease processes that are invasive and potentially lethal. These infections pose multiple diagnostic and therapeutic challenges, the foremost of which is timely identification and referral for surgical treatment. A wide spectrum of clinical entities including necrotizing fasciitis, clostridial gas gangrene, Fournier's gangrene, and invasive streptococcal cellulitis has been described under the general term "necrotizing soft tissue infection." Clinically, these infections represent a disease continuum with varying degrees of soft tissue involvement. NSTIs are associated with profound systemic manifestations including hemodynamic instability and multiorgan dysfunction/failure (MOSF). Thus, a well-organized approach to patient management is mandatory to maximize patient survival. The purpose of this article is to highlight the most important aspects of clinical presentation, diagnosis, and treatment of NSTIs.