Necrotizing Fasciitis: Pillaging the Acute Phase Response
Alexander A. Hysong, Samuel L. Posey, Deke M. Blum, Michael A. Benvenuti, Teresa Benvenuti, Samuel Johnson, Thomas J. An, Jessica K. Devin, William T. Obremskey, Jeffrey E. Martus, Stephanie N. Moore‐Lotridge, Jonathan G. Schoenecker
Abstract
➤ Necrotizing fasciitis hijacks the acute phase response, increasing the risk of developing pathophysiologic states commonly associated with death: sepsis-induced coagulopathy (SIC), systemic inflammatory response syndrome (SIRS), and adrenal insufficiency, referred to as critical illness-related corticosteroid insufficiency (CIRCI). ➤ Dynamic monitoring of SIC, SIRS, and CIRCI may be informative when assessing infection severity and when directing treatment to manage these conditions as soon as they begin to develop. ➤ To reduce the risk of oropharyngeal colonization, N95 respirators should be worn by health-care professionals who are operating on patients with necrotizing fasciitis.