A retrospective review of XXXX in Thammasat University Hospital.

@entity1 @entity137 @entity6 @entity39 @entity4 @entity281 @entity272 @entity551
OBJECTIVE: @entity39 is a rapidly progressive soft tissue @entity281 . Clinicalfeatures and microbial knowledge will help reduce mortality and morbidity from delayed diagnosis and treatment. MATERIAL AND METHOD: From January 2004 to December 2009, records of 222 @entity39 @entity1 were reviewed for the study. The following data were collected and recorded: age, sex, location of lesion, inciting event, clinical manifestation, culture and sensitivity and procedures. RESULTS: The male-to-female ratio was 1.4:1 with 56.3 years mean age. The most of the occupations were elderly who stay at home and laborers. The highest incidence rate was during the raining seasons. The most common @entity281 site was at the lower extremity with unknown inciting event. A common underlying disease was @entity6 . The major complains presented was @entity272 , fever with chill, conscious change, gastrointestinal symptom. Examination revealed @entity272 (100%), fever (50.9)%, @entity551 blood pressure (32.4%). Positive wound culture isolation was 55.9% and in blood culture was 48%. Dominant gram negative bacteria (71.98%) were in wound culture but gram positive bacteria (51.28%) were dominant in blood culture. Polymicrobial isolates in wound culture was 48% and in blood culture was 6%. The average 2.5 procedures were debridement (33.8%), skin graft coverage (59.9%), amputation (15.4%). Mortality rate was 5.9% that 46.2% were @entity6 . CONCLUSION: Gram negative organisms were predominant wound isolates whereas gram positive organisms were predominant blood isolates. With high polymicrobial isolation, clinical manifestation can be described as @entity39 . The elderly and @entity6 @entity1 were at risk. Early diagnosis is important in @entity1 with fever, @entity137 and @entity4 skin findings. The hallmarks of treatment are prompt surgical opening and debridement to get rid of the source of @entity281 and broad-spectrum antibiotics treatment administered.
