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Necrotizing fasciitis: case series and review of the literature on clinical and medico-legal diagnostic challenges
- Publication Year :
- 2018
-
Abstract
- Necrotizing fasciitis (NF) is a life-threatening infection of soft tissues spreading along the fasciae to the surrounding musculature, subcutaneous fat and overlying skin areas that can rapidly lead to septic shock and death. Due to the pandemic increase of medical malpractice lawsuits, above all in Western countries, the forensic pathologist is frequently asked to investigate post-mortem cases of NF in order to determine the cause of death and to identify any related negligence and/or medical error. Herein, we review the medical literature dealing with cases of NF in a post-mortem setting, present a case series of seven NF fatalities and discuss the main ante-mortem and post-mortem diagnostic challenges of both clinical and forensic interests. In particular, we address the following issues: (1) origin of soft tissue infections, (2) micro-organisms involved, (3) time of progression of the infection to NF, (4) clinical and histological staging of NF and (5) pros and cons of clinical and laboratory scores, specific forensic issues related to the reconstruction of the ideal medical conduct and the evaluation of the causal value/link of any eventual medical error.
- Subjects :
- Adult
Male
medicine.medical_specialty
Forensic pathology
Necrotizing fasciitis
Medical malpractice
Medical law
Clinical forensic medicine
Pathology and Forensic Medicine
03 medical and health sciences
0302 clinical medicine
LRINEC score
Diagnosis
Medicine
Humans
030216 legal & forensic medicine
Fasciitis, Necrotizing
Intensive care medicine
Fasciitis
Forensic pathology, clinical forensic medicine, necrotizing fasciitis, medical malpractice, LRINEC score
Cause of death
Retrospective Studies
business.industry
Septic shock
Soft Tissue Infections
Soft tissue
Middle Aged
medicine.disease
Italy
030220 oncology & carcinogenesis
Female
business
Medical literature
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....fb440d4a53162b4b4a32f8bdeb505927