The Management of Neonatal Acute Scrotal Necrotizing Fasciitis in a Case and Literature Review

Abstract

Abstract:

Objective: To report the diagnosis and treatment of one neonate with acute necrotizing fasciitis（NF）and explore its
clinical characteristics and key points for treatment with literature review. Methods: Based on the clinical files of this case, the
databases about neonatal acute NF were collected prior to 10th January 2019 from PubMed, METSTR, CNKI, WANFANG and then
literature reviewed. A systematic review of neotatal acute NF was presented. Results: The neonate with scrotal acute NF was cured
successfully by surgery, antibody and antishock therapies and recovered uneventfully with a 9-day hospital stay. A total of 159 articles
in Chinese and English with neonatal NF were retrieved but 184 neonate cases were reported update in 53 articles after excluding the
reviews and cases repeated calculation. There were 93 boys and 91 girls among the 184 cases and 3.5 cases per article in average, but
in only 16 cases the lesion occurred in the perineum including scrotum. After treatment, 115 cases survived with a cure rate of 62.5%
and 69 cases died with a mortality rate of 37.5%. Among the dead, 58 cases died after operation with a postoperative mortality of 33.5%
and the other 11 cases died with conservative treatment. Conclusion: Neonatal NF develops rapidly and is with dangerous prognosis
and high mortality. Prevention and correction of internal environment disorders and anti-infective therapy should be done as soon as
diagnosed and disease progress could be prevented effectively through lesion incision widely and drainage or necrotic tissue clearance
earlier to increase the chances for survival.

Key words: necrotizing fasciitis, prognosis, neonate

CLC Number:

R726

HE Jie, ZHANG Sha-Sha, SHEN Wei, LI Na, LIU Jing-Ling, WANG Ning, TUN Hua-Dong. The Management of Neonatal Acute Scrotal Necrotizing Fasciitis in a Case and Literature Review[J]. , 2019, 4(8): 16-22.

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