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Necrotizing infections

Levels of care
• First level: general practitioners: outpatients. In charge of the initial suspicion, a fundamental requirement for the early diagnosis: Apply the minimum criteria for local and general syndrome. Application of basic studies. Treatment if applicable: early indication of elective antibiotics. Urgent consultation with a surgeon.

Second level: Consultation with infectious disease, according to other specialist widespread toxic picture. Definitive diagnosis. Specialized treatment.

• Third level: Internment: advisable in all cases of clostridial and non-clostridial infections with evidence of muscle involvement (myositis) and toxic syndrome. Optional on mild cases of cellulitis without toxemia.

Studies of greater complexity.
Criteria for Placement in ICU: severe toxic syndrome. Infectious shock. Renal failure. Clotting disorders.
Discharge criteria: Correction of the toxic syndrome and its consequences. Local lesion without evidence of secondary infection and prone to scarring.

Control and monitoring of treatment:
  • Complete the period of antibiotics: usually ranges from 7-14 days for the original infection. It can range in-hospital cases of secondary infection.
  • Monitoring and healing of the lesion under local surgical debridement.
  • Control of renal function, hemostasis, liver function (possible disorders toxic syndrome).
  • Control of potential adverse effects of antibiotics. Renal and hepatic function.
  • Iatrogenic 

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