Necrotizing Fasciitis in the Lower Extremity: A Literature Review

Farheen Iqbal, B.S., Mohammad Junayed Khan, B.A.

Necrotizing fasciitis in the lower extremity is a lifethreatening soft tissue infection and is one of the few podiatric surgical emergencies. With a nonspecific clinical presentation, this infection can often be misdiagnosed. Diabetes mellitus is the most common predisposing factor. Behavioral risk factors include smoking and intravenous drug use. Necrotizing fasciitis is subdivided into three types based on bacterial etiology: type
I is a polymicrobial form, type II is a Streptococcus form, and type III is a gram negative form. In addition to clinical findings, diagnostic imaging such as ultrasound, computed tomography, and magnetic resonance imaging can assist diagnosis. Antibiotic therapy and surgical debridement are the keys to treatment, with amputation occurring frequently, especially among patients with diabetes mellitus.