Two to four types of necrotizing fasciitis

The first two are the classics, defined by a 16-patient case series:

  1. Type I: polymicrobial infections caused by Enterobacteraciae, non-Group A streptococci, and anaerobes
  2. Type II: monomicrobial infections, usually Gram-positive, and usually Group A streptococci

The next two were added later on:

  1. Type III: monomicrobial Gram-negative infections, generally caused by water-associated Vibrio vulnificans or Aeromonas hydrophila
  2. Type IV: fungal, caused by Candida species, and exceedingly rare

I’ll cite this review for those four, although there appears to be some disagreement on what constitutes Type III; many other articles refer to Type III as gas gangrene caused by Clostridium species. In this matter, I’ll defer to Mandell: it says Vibrio, so I’ll say Vibrio.

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