ABSTRACT
Necrotizing soft tissue infections (NSTIs) encompass a wide a range of soft tissue infections that can arise in skin, adipose tissue, fascia, or muscle involving any part of the body. NSTIs can manifest as mild pyoderma, necrotizing cellulitis, myositis, or severe, rapidly progressing necrotizing fasciitis. Infection typically spreads along the tissue planes causing microvascular thrombosis and ischemia, followed by further microbial invasion and tissue necrosis. The diagnosis of NSTI can be difficult, as cutaneous manifestations vary widely and may not be present at all. Once the infection has progressed, pain and signs of systemic toxicity may be out of proportion to physical findings. Unfortunately, NSTI is typically rapidly progressive, causing significant morbidity and mortality and by the time NSTI is suspected, extensive local tissue destruction has already occurred. Descriptions of NSTI date back to the fifth century when Hippocrates first described complications of Streptococcal infection.
