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Pathogens
Antimicrobials
Suggested Antimicrobial Regimen
Obtain blood cultures and CK.
Imaging does not rule out the diagnosis of a necrotizing infection.
Submit large volume tissue for culture (not swab).
Bedside incision and examination may confirm necrosis, to assist in decision to operate.
Necrotizing cellulitis, fasciitis, and myonecrosis are intraoperative diagnoses.
Necrotizing fasciitis type I
Polymicrobial infection involving aerobes and anaerobes
Necrotizing fasciitis type II
Monomicrobial infection involving Group A Streptococcus, sometimes S. aureus.
Necrotizing cellulitis
May be caused by Clostridial species contaminating existing wound (especially traumatic), or by gram negatives, other anaerobes.
Necrotizing myositis
Typically Group A Streptococcus or other beta-hemolytic streptococci.
