A 10-Year Review of Necrotizing Fasciitis in the Pediatric Population: Delays to Diagnosis and Management.
OBJECTIVE
To assess the promptness and appropriateness of management in pediatric cases of necrotizing fasciitis (NF).


METHODS
A retrospective chart review examined cases of pediatric NF treated at a pediatric tertiary care center over a 10-year period.


RESULTS
Twelve patients were identified over the 10-year period. The median (25th to 75th centile) times to appropriate antibiotic administration, infectious disease consults, surgical consults and debridement surgeries were 2.6 (2.1-3.2), 7.7 (3.4-24.4), 4.6 (1.7-21.0), and 22.1 (10.3-28.4) hours following assessment at triage. The initial antibiotic(s) administered covered the causative organism in 9 of 12 cases. The median (25th to 75th centile) length of hospital stay was 21 (14.0-35.5) days.


CONCLUSIONS
The large variability in the care of these patients speaks to the range of their presenting symptomatology. The lack of a standardized approach to the pediatric patient with suspected NF results in delays in management and suboptimal antibiotic choice.
['VanderMeulen|Heather|H|', 'Pernica|Jeffrey M|JM|', 'Roy|Madan|M|', 'Kam|April J|AJ|']
D000293:Adolescent D000900:Anti-Bacterial Agents D002648:Child D002675:Child, Preschool D003646:Debridement D019115:Fasciitis, Necrotizing D005260:Female D006801:Humans D007223:Infant D007902:Length of Stay D008297:Male D009864:Ontario D012017:Referral and Consultation D012189:Retrospective Studies D013997:Time Factors D016896:Treatment Outcome D014218:Triage
necrotizing fasciitis pediatric emergency medicine quality improvement soft tissue infection