[Necrotizing fasciitis of the upper limb. Apropos of a case]

Abstract

Necrotizing fasciitis is a rare infection, serious because of its risk of functional sequelae and mortality. The first clinical and histological descriptions of acute Streptococcal infection of the fascia were published in 1924 by Meleney, who referred to this condition as "Streptococcal haemolytic gangrene". However, since Meleney, numerous authors have reported cases of necrotizing fasciitis due to a wide range of bacteria. The authors report a case of necrotizing fasciitis of the upper limb in a 45 year old man following a superficial lesion of the dorsum of the hand. Despite the use of antibiotics, the morbidity and mortality of this disease are still high. Treatment is surgical and must be performed urgently. A review of the literature groups together the published cases and analyses the various aetiologies and risk factors.