Necrotizing Fasciitis in Children: Report of Two Cases and Review of the Literature

Necrotizing fasciitis (NF) is a potentially lethal soft-tissue infection characterized by extensive fascial and subcutaneous tissue necrosis. Early recognition, treatment with antibiotics, and aggressive surgical débridement are crucial to successful outcome. Necrotizing fasciitis recently received widespread publicity with the report of six cases in British patients, three of whom died.¹However, no increase in the incidence of systemic group A β-hemolytic streptococci (GABHS) infections in England was actually documented during early 1994 compared with the preceding 2 years.¹Although isolated cases of NF in infants and children have been reported, the entity has received relatively little attention in the pediatric literature. The subject was last generally reviewed in the pediatric literature over 20 years ago.²We report two cases of NF in children that were caused by GABHS, review the literature of pediatric NF, and detail newer diagnostic and therapeutic modalities. Patient Reports.Patient 1. A 5-year-old,