Early recognition of neonatal abdominal wall necrotizing fasciitis
Necrotizing fasciitis (NF) of the abdominal wall occurring in newborns is associated with a 50% mortality rate. Improved survival requires early diagnosis followed by aggressive surgical débridement. During a 10-year period, we treated 7 infants who developed NF. During the same period, 32 infants w...
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| Veröffentlicht in: | The American journal of surgery 1994-05, Vol.167 (5), p.481-484 |
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| creator | Sawin, Robert S. Schaller, Robert T. Tapper, David Morgan, Alan Cahill, John |
| description | Necrotizing fasciitis (NF) of the abdominal wall occurring in newborns is associated with a 50% mortality rate. Improved survival requires early diagnosis followed by aggressive surgical débridement. During a 10-year period, we treated 7 infants who developed NF. During the same period, 32 infants were admitted with omphalitis that did not progress to NF. The patients with omphalitis and those with NF were compared. Tachycardia, abnormal white blood cell counts, induration, and violaceous skin discoloration were seen exclusively in the NF patients. Polymicrobial infections were documented in 28% of the omphalitis patients and 86% of the NF patients. All omphalitis patients survived, whereas 5 of 7 (71%) NF patients died. Adjuvant hyperbaric oxygen therapy was used for 4 infants with NF, 2 of whom survived (50%). NF is a highly morbid disease, that can be distinguished from other infant abdominal wall infections by the skin changes, white blood cell counts, heart rate, and microbiologic results. Prompt diagnosis of NF improves survival when combined with aggressive surgical débridement. |
| doi_str_mv | 10.1016/0002-9610(94)90239-9 |
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Improved survival requires early diagnosis followed by aggressive surgical débridement. During a 10-year period, we treated 7 infants who developed NF. During the same period, 32 infants were admitted with omphalitis that did not progress to NF. The patients with omphalitis and those with NF were compared. Tachycardia, abnormal white blood cell counts, induration, and violaceous skin discoloration were seen exclusively in the NF patients. Polymicrobial infections were documented in 28% of the omphalitis patients and 86% of the NF patients. All omphalitis patients survived, whereas 5 of 7 (71%) NF patients died. Adjuvant hyperbaric oxygen therapy was used for 4 infants with NF, 2 of whom survived (50%). NF is a highly morbid disease, that can be distinguished from other infant abdominal wall infections by the skin changes, white blood cell counts, heart rate, and microbiologic results. Prompt diagnosis of NF improves survival when combined with aggressive surgical débridement.</description><identifier>ISSN: 0002-9610</identifier><identifier>EISSN: 1879-1883</identifier><identifier>DOI: 10.1016/0002-9610(94)90239-9</identifier><identifier>PMID: 8185031</identifier><identifier>CODEN: AJSUAB</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Abdomen ; Abdominal Muscles ; Abdominal wall ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Anti-Bacterial Agents - therapeutic use ; Biological and medical sciences ; Blood ; Debridement ; Diagnosis ; Discoloration ; Emergency and intensive care: neonates and children. Prematurity. Sudden death ; Fasciitis ; Fasciitis - diagnosis ; Fasciitis - etiology ; Fasciitis - therapy ; Heart rate ; Humans ; Hyperbaric oxygen therapy ; Hyperbaric Oxygenation ; Infant, Newborn ; Infants ; Inflammation - complications ; Intensive care medicine ; Leukocytes ; Medical sciences ; Necrosis ; Necrotizing fasciitis ; Neonates ; Omphalitis ; Skin ; Survival ; Tachycardia ; Umbilicus</subject><ispartof>The American journal of surgery, 1994-05, Vol.167 (5), p.481-484</ispartof><rights>1994</rights><rights>1994 INIST-CNRS</rights><rights>Copyright Elsevier Limited May 1994</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c414t-a2c137fcc1a6451780e3e70b07505f640c7fcc3300f2f7863223c08ca14a51323</citedby><cites>FETCH-LOGICAL-c414t-a2c137fcc1a6451780e3e70b07505f640c7fcc3300f2f7863223c08ca14a51323</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/2847451300?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>309,310,314,780,784,789,790,3550,23930,23931,25140,27924,27925,45995,64385,64387,64389,72469</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=4183993$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/8185031$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sawin, Robert S.</creatorcontrib><creatorcontrib>Schaller, Robert T.</creatorcontrib><creatorcontrib>Tapper, David</creatorcontrib><creatorcontrib>Morgan, Alan</creatorcontrib><creatorcontrib>Cahill, John</creatorcontrib><title>Early recognition of neonatal abdominal wall necrotizing fasciitis</title><title>The American journal of surgery</title><addtitle>Am J Surg</addtitle><description>Necrotizing fasciitis (NF) of the abdominal wall occurring in newborns is associated with a 50% mortality rate. Improved survival requires early diagnosis followed by aggressive surgical débridement. During a 10-year period, we treated 7 infants who developed NF. During the same period, 32 infants were admitted with omphalitis that did not progress to NF. The patients with omphalitis and those with NF were compared. Tachycardia, abnormal white blood cell counts, induration, and violaceous skin discoloration were seen exclusively in the NF patients. Polymicrobial infections were documented in 28% of the omphalitis patients and 86% of the NF patients. All omphalitis patients survived, whereas 5 of 7 (71%) NF patients died. Adjuvant hyperbaric oxygen therapy was used for 4 infants with NF, 2 of whom survived (50%). NF is a highly morbid disease, that can be distinguished from other infant abdominal wall infections by the skin changes, white blood cell counts, heart rate, and microbiologic results. Prompt diagnosis of NF improves survival when combined with aggressive surgical débridement.</description><subject>Abdomen</subject><subject>Abdominal Muscles</subject><subject>Abdominal wall</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Anti-Bacterial Agents - therapeutic use</subject><subject>Biological and medical sciences</subject><subject>Blood</subject><subject>Debridement</subject><subject>Diagnosis</subject><subject>Discoloration</subject><subject>Emergency and intensive care: neonates and children. Prematurity. Sudden death</subject><subject>Fasciitis</subject><subject>Fasciitis - diagnosis</subject><subject>Fasciitis - etiology</subject><subject>Fasciitis - therapy</subject><subject>Heart rate</subject><subject>Humans</subject><subject>Hyperbaric oxygen therapy</subject><subject>Hyperbaric Oxygenation</subject><subject>Infant, Newborn</subject><subject>Infants</subject><subject>Inflammation - complications</subject><subject>Intensive care medicine</subject><subject>Leukocytes</subject><subject>Medical sciences</subject><subject>Necrosis</subject><subject>Necrotizing fasciitis</subject><subject>Neonates</subject><subject>Omphalitis</subject><subject>Skin</subject><subject>Survival</subject><subject>Tachycardia</subject><subject>Umbilicus</subject><issn>0002-9610</issn><issn>1879-1883</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1994</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp9kUuP0zAQgC0EWkrhH4AUCYR2D4GZ2EnsC9LuqixIlbjA2XJdu3KVxsVOWC2_nsk26oHDnvyYbx7-zNhbhE8I2HwGgKpUDcKlElcKKq5K9YwtULaqRCn5c7Y4Iy_Zq5z3dEQU_IJdSJQ1cFywm5VJ3UORnI27Pgwh9kX0Re9ibwbTFWazjYfQ0-7edB3d2xSH8Df0u8KbbANl5NfshTdddm_mdcl-fV39vP1Wrn_cfb-9XpdWoBhKU1nkrbcWTSNqbCU47lrYQFtD7RsBdgpyDuAr38qGVxW3IK1BYWrkFV-yj6e6xxR_jy4P-hCydV1naNwx67YRshZKEvj-P3Afx0SPyLqSoqXm1IQocaLoSTkn5_UxhYNJDxpBT4L1ZE9P9rQS-lGwVpT2bi4-bg5ue06ajVL8wxwnP6bzyfQ25DMmUHKlOGFfTpgjY3-CS5psut66baC_GPQ2hqfn-AcylpSw</recordid><startdate>19940501</startdate><enddate>19940501</enddate><creator>Sawin, Robert S.</creator><creator>Schaller, Robert T.</creator><creator>Tapper, David</creator><creator>Morgan, Alan</creator><creator>Cahill, John</creator><general>Elsevier Inc</general><general>Elsevier</general><general>Elsevier Limited</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>19940501</creationdate><title>Early recognition of neonatal abdominal wall necrotizing fasciitis</title><author>Sawin, Robert S. ; Schaller, Robert T. ; Tapper, David ; Morgan, Alan ; Cahill, John</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c414t-a2c137fcc1a6451780e3e70b07505f640c7fcc3300f2f7863223c08ca14a51323</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1994</creationdate><topic>Abdomen</topic><topic>Abdominal Muscles</topic><topic>Abdominal wall</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Anti-Bacterial Agents - therapeutic use</topic><topic>Biological and medical sciences</topic><topic>Blood</topic><topic>Debridement</topic><topic>Diagnosis</topic><topic>Discoloration</topic><topic>Emergency and intensive care: neonates and children. Prematurity. Sudden death</topic><topic>Fasciitis</topic><topic>Fasciitis - diagnosis</topic><topic>Fasciitis - etiology</topic><topic>Fasciitis - therapy</topic><topic>Heart rate</topic><topic>Humans</topic><topic>Hyperbaric oxygen therapy</topic><topic>Hyperbaric Oxygenation</topic><topic>Infant, Newborn</topic><topic>Infants</topic><topic>Inflammation - complications</topic><topic>Intensive care medicine</topic><topic>Leukocytes</topic><topic>Medical sciences</topic><topic>Necrosis</topic><topic>Necrotizing fasciitis</topic><topic>Neonates</topic><topic>Omphalitis</topic><topic>Skin</topic><topic>Survival</topic><topic>Tachycardia</topic><topic>Umbilicus</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sawin, Robert S.</creatorcontrib><creatorcontrib>Schaller, Robert T.</creatorcontrib><creatorcontrib>Tapper, David</creatorcontrib><creatorcontrib>Morgan, Alan</creatorcontrib><creatorcontrib>Cahill, John</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sawin, Robert S.</au><au>Schaller, Robert T.</au><au>Tapper, David</au><au>Morgan, Alan</au><au>Cahill, John</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Early recognition of neonatal abdominal wall necrotizing fasciitis</atitle><jtitle>The American journal of surgery</jtitle><addtitle>Am J Surg</addtitle><date>1994-05-01</date><risdate>1994</risdate><volume>167</volume><issue>5</issue><spage>481</spage><epage>484</epage><pages>481-484</pages><issn>0002-9610</issn><eissn>1879-1883</eissn><coden>AJSUAB</coden><abstract>Necrotizing fasciitis (NF) of the abdominal wall occurring in newborns is associated with a 50% mortality rate. Improved survival requires early diagnosis followed by aggressive surgical débridement. During a 10-year period, we treated 7 infants who developed NF. During the same period, 32 infants were admitted with omphalitis that did not progress to NF. The patients with omphalitis and those with NF were compared. Tachycardia, abnormal white blood cell counts, induration, and violaceous skin discoloration were seen exclusively in the NF patients. Polymicrobial infections were documented in 28% of the omphalitis patients and 86% of the NF patients. All omphalitis patients survived, whereas 5 of 7 (71%) NF patients died. Adjuvant hyperbaric oxygen therapy was used for 4 infants with NF, 2 of whom survived (50%). NF is a highly morbid disease, that can be distinguished from other infant abdominal wall infections by the skin changes, white blood cell counts, heart rate, and microbiologic results. Prompt diagnosis of NF improves survival when combined with aggressive surgical débridement.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>8185031</pmid><doi>10.1016/0002-9610(94)90239-9</doi><tpages>4</tpages></addata></record> |
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| subjects | Abdomen Abdominal Muscles Abdominal wall Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Anti-Bacterial Agents - therapeutic use Biological and medical sciences Blood Debridement Diagnosis Discoloration Emergency and intensive care: neonates and children. Prematurity. Sudden death Fasciitis Fasciitis - diagnosis Fasciitis - etiology Fasciitis - therapy Heart rate Humans Hyperbaric oxygen therapy Hyperbaric Oxygenation Infant, Newborn Infants Inflammation - complications Intensive care medicine Leukocytes Medical sciences Necrosis Necrotizing fasciitis Neonates Omphalitis Skin Survival Tachycardia Umbilicus |
| title | Early recognition of neonatal abdominal wall necrotizing fasciitis |
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