PRACTICE POINTER: Necrotising fasciitis

LEARNING POINTS Necrotising fasciitis is a lethal and rapidly progressive soft tissue infection, which can occur in healthy young patients People with diabetes, those who inject drugs, and patients with haematological malignancy are particularly at risk Diagnosis requires a high index of suspicion. Consider necrotising fasciitis especially when the presentation is "not quite right" or the patient is not responding to treatment Early surgical exploration of the soft tissues has little morbidity and may be the only means to reach a definitive diagnosis and expedite treatment In established necrotising fasciitis, surgery gives a 60-80% chance of survival. The earlier the first exploration and subsequent debridement, the less extensive the resection and postoperative morbidity is likely to be