Necrotizing Fasciitis in a Neonate

Necrotizing staphylococcal fasciitis is an infrequent yet devastating clinical entity resulting in widespread skin loss, systemic toxicity, and severe catabolic wastage. Unless the condition is recognized promptly and treated vigorously, the mortality is very high. Critical features of management include elimination of the infecting agent, usually with penicillin G potassium and methicillin sodium, vigorous debridement, metabolic support including generous protein replacement, and early covering of the open wound first with homografts or heterografts and then with autografts. A neonate weighing 2,700 gm (5 lb 15 oz) survived necrotizing staphylococcal fasciitis.