Necrotising Fasciitis (skin infection)

Question 1

What is necrotising fasciitis?

Answer 1

life-threatening subcutaneous soft-tissue infection

Question 2

What are the symptoms?

Answer 2

rapidly progressing soft tissue infection
severe pain
numbness over pain site
oedema
erythema
systemic signs of infection
fever
palpitations, tachycardia, tachypnoea, hypotension, lightheadedness

Question 3

What are the risk factors of necrotising fasciitis?

Answer 3

inpatient contact
varicella zoster infection
cutaneous injury, surgery, trauma
non-traumatic skin lesions
DM
malignancy
chronic liver disease

Question 4

How is necrotising fasciitis diagnosed?

Answer 4

initial investigations
- clean wound, remove all kyperkeratotic skin
- blood and tissue cultures
- gram stain
- FBC
then
- consider CT, MRI, x-ray, ultrasound

Question 5

How is necrotising fasciitis treated?

Answer 5

IV flucloxacillin (7 days if mild, 10-14 days if moderate or severe)