Necrotising Fasciitis

Question 1

What is necrotising fasciitis?

Answer 1

A life-threatening bacterial infection characterised by rapidly spreading necrosis of the fascia and subcutaneous tissues.

Question 2

What is the most common cause of necrotising fasciitis?

Answer 2

Streptococcus pyogenes

Question 3

What is type 1 necrotising fasciitis?

Answer 3

Cause is polymicrobial - a mix of anaerobes and aerobes

Question 4

What is type 2 necrotising fasciitis?

Answer 4

Caused by streptococcus pyogenes

Question 5

What types of patients does type 1 necrotising fasciitis typically appear in?

Answer 5

Diabetics
Patients with cancer
Immunocompromised

Question 6

What are the risk factors for necrotising fasciitis?

Answer 6

Recent trauma
Burns
Skin infection
Diabetes
SGLT-2 inhibitors
IVDU
Immunosuppression

Question 7

What is the early presentation of necrotising fasciitis?

Answer 7

Intense pain out of proportion to visible findings
Skin puncture or injury
Flu-like symptoms
Erythema, warmness, swelling and tenderness
Hypersensitive skin
Fever

Question 8

What are the advances signs of necrotising fasciitis?

Answer 8

Gas or crepitus
Skin necrosis
Purple/blue skin discolouration
Fever
Reduced sensation
Hypotension
Tachycardia

Question 9

What is the management of necrotising fasciitis?

Answer 9

Immediate surgical debridement
IV broad spectrum antibiotics
Fluid resuscitation/ replacement
Amputation in severe/late cases

Question 10

What are the complications of necrotising fasciitis?

Answer 10

Fournier’s gangrene
Sepsis
Death
Long-term disability