A 10-Year Review of Necrotizing Fasciitis in the Pediatric Population: Delays to Diagnosis and Management.

OBJECTIVE: To assess the promptness and appropriateness of management in pediatric cases of necrotizing fasciitis (NF).

METHODS: A retrospective chart review examined cases of pediatric NF treated at a pediatric tertiary care center over a 10-year period.

RESULTS: Twelve patients were identified over the 10-year period. The median (25th to 75th centile) times to appropriate antibiotic administration, infectious disease consults, surgical consults and debridement surgeries were 2.6 (2.1-3.2), 7.7 (3.4-24.4), 4.6 (1.7-21.0), and 22.1 (10.3-28.4) hours following assessment at triage. The initial antibiotic(s) administered covered the causative organism in 9 of 12 cases. The median (25th to 75th centile) length of hospital stay was 21 (14.0-35.5) days.

CONCLUSIONS: The large variability in the care of these patients speaks to the range of their presenting symptomatology. The lack of a standardized approach to the pediatric patient with suspected NF results in delays in management and suboptimal antibiotic choice.