A 64-year-old gentleman presents to the ED with a 12-hour history of malaise and increasing pain, redness and swelling of his left hand. He reports sustaining a small cut to his left palm whilst gardening the day before.
His past medical history was notable only for type 2 diabetes and prostate cancer (well controlled on hormone therapy for a number of years). He takes only Metformin, Aspirin, Simvastatin and 3 monthly hormone injections. He had his flu vaccination 2 weeks prior to the onset of symptoms.
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Which of the following features in the history are risk factors for the development of necrotising fasciitis?
Which organism is most commonly implicated in type 2 necrotising fasciitis which favours the limbs?
What constitutes the definitive management of necrotising fasciitis?
Which antibiotic is felt to 'switch off' toxin production in necrotising fasciitis, and so should be given early?
