[Epidemiology, clinical manifestations and microbiology of children with necrotizing fasciitis in a Costa Rican pediatric hospital].

Naranjo-Zúñiga, Gabriela; Yock-Corrales, Adriana; Mora-Mesén, Cinthya; Campos-Villalobos, Marisol; Ulloa-Gutierrez, Rolando

BACKGROUND Despite the significant associated morbidity of necrotizing fasciitis (NF), few studies have been published and this is the larger pediatric series in Latin America. AIM To describe the epidemiology, clinical characteristics and microbiology of NF in Costa Rican children. METHODS Review of clinical and pathological records, period April 2002 to April 2014, in patients under 13 years of age. RESULTS 19/22 patients met the inclusion requirement, 12 had co-morbidity: 26% with a history of recent surgery and 21% were neonates. Etiology was documented in blood cultures in 26% and by tissue culture in 63% (one third of them polymicrobial). Pseudomonas aeruginosa, Escherichia coli and Staphylococcus aureus were the three most common etiologic agents. Case fatality rate was 42%, one of the highest in our region. CONCLUSION NF is a serious, unusual pathology, frequently associated with neonatology and post-surgical patients, with a mixed etiology that requires the association of antimicrobials and early surgery. Its lethality is high in our setting, over previously published series.