PREVALENCE OF NECROTIZING FASCIITIS DURING RAMADAN AND HAJJ 1427-H
Abstract
Background: Necrotizing Fasciitis is a rare progressive disease which results in significant rate ofmortality and morbidity if there is any delay in diagnosis and treatment. Objectives of this Prospective
observational study were to share our experience of dealing necrotizing fasciitis in terms of different
presentations, diagnosis, treatment and outcome during Ramadan and Hajj. It was conducted in the
Department of General Surgery, Al-Noor Specialist Hospital, Holly Makkah, KSA during Ramadan and
Hajj period from 1-8-1427 to 30-1-1428. Methods: Total 35 patients >12 years of age, irrespective of
the gender belonging to different nationalities admitted to Al-Noor specialist hospital, Makkah, KSA
were included in this study to evaluate the different causative factors, presentations, response to
medical/ surgical treatment and outcome. Results: Total 35 patients with male to female ratio of 6:1
were admitted during Ramadan and hajj period from 1-8-1427 to 30-1-1428 (six months) with the
features of necrotizing Fasciitis. Out of these 35 patients, 23 (65.7%) were hajji and 12 (34.28%) were
residents (Both Saudi and non Saudi) with a ratio of 2:1. Major co-morbid factors were old age, diabetes
mellitus, hypertension and renal failure. Among systemic manifestations, 4 (11.42%) developed septic
shock and admitted to ICU, 4 (11.42%) needed ventilator support for respiratory failure, and 5 (14.28%)
patients developed Myocardial infarction. After resuscitation, 33 patients under went aggressive surgical
debridement and two patients died before surgery. Microbiology revealed, 15 (42.85%) Streptococcus
Group-A infection, l3 (8.51%) Polymicrobial and 4 (11.42%) MRSA. Diagnosis was conformed by
histopathology. Mortality rate was 11.5%. Conclusion: Better outcome in necrotizing fasciitis depends
upon early presentation, prompt diagnosis and aggressive surgical debridement. There was strong
correlation between severity of necrotizing fasciitis and co morbid factors, general condition at
presentation, systemic toxicity and raised WBC count.
Keywords: Necrotizing fasciitis, Septic shock, Bullae, Blister
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