Soft tissue infections is usually caused by bacteria, such as staphylococci or streptococci that are commonly present on the skin or mucus membranes of the nose or mouth of otherwise normal and healthy people. The infection develops when there is a break in the skin, such as a wound or injury, which may be minor. This allows bacteria to enter the skin and grow, causing infection and swelling. Often the infections are mild and heal completely with antibiotic treatment. However, some cases of tissue can be severe and lead to generalized infection. Thus it is important to seek medical care promptly if the infection is associated with fever, rapid worsening, or other signs of progression.
Necrotizing soft tissue infections (NSTIs) are the most extreme and severe end of skin and soft tissue infections. These infections are rapidly spreading and can progress in inches per hour with extensive tissue necrosis as a result. The vast majority of patients require intensive care and extensive surgical interventions to remove necrotic tissue, and despite modern intensive care, the mortality associated with NSTIs is high, often exceeding 30%. Patients affected by NSTIs are highly heterogeneous, ranging from young immunocompetent individuals to individuals with co-morbidities, including among others diabetes mellitus, peripheral vascular disease, chronic renal failure, and recent trauma. The fulminant course of NSTIs (in the order of hours) demands immediate diagnosis and adequate interventions to salvage lives and limbs. Although, it is undisputed that rapid diagnosis and prompt intervention is directly related to survival, the diagnosis is often difficult due to vague initial symptoms that may result in a doctor’s delay, and treatment is complicated due to the great heterogeneity of these infections, including a wide variety of causative microorganisms and varying co-morbidities. Recent reports have underscored the urgent need for improved diagnosis as well as evidence-based schemes for identification and management of these sever tissue infections. The overall goal with INFECT is to advance our understanding of the pathophysiological mechanisms, prognosis, and diagnosis of the multifactorial highly lethal NSTIs.