CLINICAL SIGNS AND SYMPTOMS AT DIFFERENT STAGES OF NECROTIZING FASCIITIS

Introduction. Necrotizing fasciitis (NF) is a severe and life-threatening disease affecting soft tissues, including fascia and subcutaneous tissue, characterized by rapid progression that can lead to widespread tissue necrosis, systemic intoxication, and even death if diagnosis and treatment are delayed. Early recognition of clinical symptoms is crucial for a timely diagnosis.The aim of the study was to investigate the peculiarities of the progression of clinical signs of necrotizing fasciitis at different stages before the hospitalization period.Materials and methods of the study. The primary medical records of 150 patients who were treated for necrotizing fasciitis at the clinical bases of Danylo Halytsky Lviv National Medical University during 1999-2024 were analyzed.Results and discussion. As a result of the analysis, all signs and symptoms were divided into 3 groups: early symptoms, severe symptoms, and critical symptoms. The early symptoms included: swelling and an increase in the volume of the anatomical segment; pain disproportionate to the visible pathological process or history; changes in the skin surface in the form of a “lemon peel”; hypersensitivity or loss of sensitivity of the skin surface; skin discoloration; delayed capillary filling of the skin and changes in local skin temperature. The following were considered to be “severe symptoms” of NF: subepidermal blisters with transparent contents; increase in the number or size of blisters, appearance of blisters with hemorrhagic or cloudy contents; rapid extensive expansion of the pathological process zone; involvement of more than one anatomical segment by the pathological process; lack of effect from conservative treatment; systemic signs of infection (SIRS) and signs of intoxication; fever, hypotension, leukocytosis, hyperglycemia, hyponatremia. The critical symptoms of NF included: skin necrosis in the setting of all (or most) of the previous symptoms; crepitation (or gas formation) in the subcutaneous tissue; hypotension, multiple organ failure, and septic shock.Conclusions. Clinical symptoms of HF are dynamic and depend on the stage of the disease. Timely early recognition of both the slightest initial and critical symptoms is the key to saving lives. Doctors of all specialties should be familiar with the manifestations of this disease. This will reduce mortality and improve treatment outcomes.