Context

Necrotising fasciitis is a rare but life threatening bacterial soft tissue infection. It is associated with significant mortality mortality of approximately 20-40%, even with appropriate treatment1-3, and morbidity from skin and soft tissue loss2. Current literature suggests that there are approximately 500 new cases of necrotising fasciitis occurring annually in the UK. However, as there is no ongoing surveillance programme, this is felt to be an underestimation2,4.

A high index of clinical suspicion, prompt administration of broad-spectrum antibiotics and emergency surgery to debride affected tissues are key to improving survival. Otherwise, rapid progression to multiorgan failure can occur, leading to systemic toxicity, limb loss and death5. Mortality is directly proportional to delay in diagnosis and treatment6-8.

Learning Bite

Necrotising fasciitis is rare but associated with significant morbidity and mortality. It represents a time critical pathology where patient outcome is directly influenced by time to diagnosis and treatment. A high index of suspicion is required to make the diagnosis at the earliest opportunity.

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