Necrotizing soft tissue infections (NSTIs) rank among the more difficult disease processes
encountered by physicians and surgeons. NSTIs can arise primarily in the dermis and
epidermis, but they more commonly affect the deeper layers of adipose tissue, fascia, or
muscle. NSTIs are typically caused by toxin-producing bacteria and are characterized
clinically by very rapid progression of disease with significant local tissue destruction.
Varying amounts of early or late systemic toxicity depend on the strain of bacteria and toxins …