Figure 2.30. This infant has necrotizing fasciitis of the abdominal wall, which is a rapidly progressive acute necrotizing infection of the skin, subcutaneous tissue, muscle, and fascia. Necrotizing fasciitis usually presents as an area of cellulitis with fever, redness, and edema. It rapidly progresses to central patches of bluish discoloration followed by ulceration, gangrene, and toxicity. Necrotizing fasciitis is a surgical emergency as it is rapidly fatal if not treated aggressively by widespread incision and debridement. Infection in this condition has been associated with Staphylococcus aureus, anaerobic Streptococcus, Bacteroides and Proteus.
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