PREVALENCE OF NECROTIZING FASCIITIS DURING RAMADAN AND HAJJ 1427-H
AbstractBackground: 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 Prospectiveobservational study were to share our experience of dealing necrotizing fasciitis in terms of differentpresentations, diagnosis, treatment and outcome during Ramadan and Hajj. It was conducted in theDepartment of General Surgery, Al-Noor Specialist Hospital, Holly Makkah, KSA during Ramadan andHajj period from 1-8-1427 to 30-1-1428. Methods: Total 35 patients >12 years of age, irrespective ofthe gender belonging to different nationalities admitted to Al-Noor specialist hospital, Makkah, KSAwere included in this study to evaluate the different causative factors, presentations, response tomedical/ surgical treatment and outcome. Results: Total 35 patients with male to female ratio of 6:1were admitted during Ramadan and hajj period from 1-8-1427 to 30-1-1428 (six months) with thefeatures of necrotizing Fasciitis. Out of these 35 patients, 23 (65.7%) were hajji and 12 (34.28%) wereresidents (Both Saudi and non Saudi) with a ratio of 2:1. Major co-morbid factors were old age, diabetesmellitus, hypertension and renal failure. Among systemic manifestations, 4 (11.42%) developed septicshock 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 surgicaldebridement and two patients died before surgery. Microbiology revealed, 15 (42.85%) StreptococcusGroup-A infection, l3 (8.51%) Polymicrobial and 4 (11.42%) MRSA. Diagnosis was conformed byhistopathology. Mortality rate was 11.5%. Conclusion: Better outcome in necrotizing fasciitis dependsupon early presentation, prompt diagnosis and aggressive surgical debridement. There was strongcorrelation between severity of necrotizing fasciitis and co morbid factors, general condition atpresentation, systemic toxicity and raised WBC count.Keywords: Necrotizing fasciitis, Septic shock, Bullae, Blister
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