Necrotising Fasciitis - Clinical Scenario

A 45-year-old male presents with severe pain, swelling, and blistering of the right leg after a minor injury, suggesting necrotising fasciitis. Immediate clinical focus is on identifying pathognomonic signs and initiating swift, effective treatment.
Necrotising Fasciitis - Clinical Scenario


Clinical Scenario

A 45-year-old male arrives at the emergency department with severe pain in his right leg, which has increased in intensity over the past 24 hours. The leg is swollen, erythematous, and warm to the touch. There are also some dark, blistering areas on the skin.

The patient mentions a minor cut on his leg from gardening a few days ago. He has a history of poorly controlled diabetes mellitus type 2.

Parameters: Heart rate 145 bpm, Blood pressure 85/60, Temperature 38.4, Confused.

Objectives:
1. Identify the pathognomonic signs of necrotising fasciitis.
2. Identify the risk factors for necrotising fasciitis.
3. Knowledge of relevant tests to help in making a diagnosis.
4. Management plan for patients with suspected necrotising fasciitis.
5. Identify and discuss any adjunctive therapies.

Primary Contributor: Dr Kurt Lee Chircop, Plastic Surgery Trainee, Malta.

Reviewer: Dr Waraguru Wanjau, Plastic Surgery Trainee, South Africa.

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