NECROTIZING FASCIITIS: - A NARRATIVE REVIEW OF EPIDEMIOLOGY, PATHOGENESIS, AND EMERGING THERAPIES IN WESTERN UGANDA

Necrotizing fasciitis (NF) is a rapidly progressing soft tissue infection with high mortality, characterized by fascial necrosis and systemic toxicity. Despite advances in surgical and antimicrobial therapies, NF remains a clinical challenge. This narrative review examines its epidemiology, pathogenesis, and emerging treatments. NF is primarily polymicrobial, with Group A Streptococcus (GAS) and mixed anaerobic-aerobic infections being most common. Pathogenesis involves bacterial virulence, immune evasion, and host susceptibility (e.g., diabetes, immunosuppression). Early surgical debridement and broad-spectrum antibiotics remain the cornerstone of treatment, while emerging therapies—such as immunomodulation (IVIG, hyperbaric oxygen), novel antimicrobials, and bacteriophage therapy—show promise. A multidisciplinary approach is essential, and further trials are needed to validate new treatments.