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Necrotizing fasciitis of the vulva

  • Author Footnotes
    1 From the Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina.
    Hale Stephenson
    Footnotes
    1 From the Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina.
    Affiliations
    Chapel Hill, North Carolina
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  • Author Footnotes
    1 From the Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina.
    Deborah J. Dotters
    Correspondence
    Reprint requests: Deborah J. Dotters, MD, School of Medicine, Department of Obstetrics and Gynecology, The University of North Carolina, CB# 7570, Old Clinic Bids., Chapel Hill, NC 27599.
    Footnotes
    1 From the Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina.
    Affiliations
    Chapel Hill, North Carolina
    Search for articles by this author
  • Author Footnotes
    1 From the Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina.
    Vern Katz
    Footnotes
    1 From the Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina.
    Affiliations
    Chapel Hill, North Carolina
    Search for articles by this author
  • Author Footnotes
    1 From the Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina.
    William Droegemueller
    Footnotes
    1 From the Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina.
    Affiliations
    Chapel Hill, North Carolina
    Search for articles by this author
  • Author Footnotes
    1 From the Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina.
      This paper is only available as a PDF. To read, Please Download here.
      Objective: We attempted to characterize the natural history of necrotizing fasciitis of the vulva.
      Study Design: The records of 29 nonpregnant women with necrotizing fasciitis of the vulva were evaluated.
      Results: These women experienced a rapidly progressing polymicrobial infection. Initially, the infections in many women were thought to be labial cellulitis, appearing mild and innocuous. Delays in recognition and aggressive surgical management were associated with increased morbidity and mortality. Of 15 women with a delay >48 hours between presentation and treatment, 11 died. Twenty of 29 (69%) were diabetic, accounting for 11 of the 14 deaths.
      Conclusion: Early diagnosis and aggressive surgical debridement in spite of mild symptoms will improve outcome in this serious disease process.

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