TY - CHAP M1 - Book, Section TI - Necrotizing Soft Tissue Infections A1 - Urbina, Tomas A1 - Prost, Nicolas de A2 - Schmidt, Gregory A. A2 - Kress, John P. A2 - Douglas, Ivor S. Y1 - 2023 N1 - T2 - Hall, Schmidt and Wood’s Principles of Critical Care, 5th Edition AB - KEY POINTSNecrotizing soft tissue infections (NSTIs) are life-threatening soft tissue infections defined by a necrotizing component involving any or all the layers of the soft tissue compartment.NSTIs of the extremities, mainly of the lower limb, represent the most common condition.Most NSTIs involve polymicrobial pathogens; In 20% to 30% of cases, NSTIs are monomicrobials and primarily involve Group A streptococcus (GAS).The “gold standard” to confirm the diagnosis of NSTI is surgical exploration.In patients with sepsis or septic shock, imaging (CT scan and/or MRI) must never delay surgery.The key early therapeutic interventions required are broad-spectrum antibiotics and debridement surgery.The mainstem of empiric treatment is a broad-spectrum beta-lactam with additional aminoglycosides in case of septic shock. Clindamycin should be added in case of documented or suspected (GAS) infection. SN - PB - McGraw Hill CY - New York, NY Y2 - 2024/10/13 UR - accesssurgery.mhmedical.com/content.aspx?aid=1201806178 ER -