In conclusion, in our hospital 42% of all monomicrobial NF cases
were caused by Gram-negative pathogens. The rates of E. coli NF
were comparable to GAS NF (22%). The affected population
included mostly patients with malignancy or diabetes mellitus,
and the 30-day mortality rate was higher than in Gram-positive
NF. The early diagnosis of Gram-negative NF is hampered by lower
CRP and creatinine levels and the absence of elevated CPK in
addition to lower absolute values of CPK compared with Gram-positive infections. Physicians should be aware that Gram-negative organisms may be responsible for necrotizing fasciitis
and prescribe empirical coverage accordingly.