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Necrotising Fasciitis (Clinical presentation (Infection track rapidly…
Necrotising Fasciitis
Key Facts
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Two forms
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Type 2
Caused by group A beta-haemolytic streptococci, arises in previously healthy patients
This is a deep-seated infection of the subcutaneous tissue that results in a fulminant and spreading destruction of fascia and fat but may initially SPARE the skin (eventually also destroyed)
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Clinical presentation
Infection track rapidly along the tissue planes, causing spreading erythema, pain and sometimes crepitus (crackling sound when joint moves)
In patients with fever, toxicity and pain that is out of proportion to the skin findings - necrotising fasciitis should be suspected
Severe pain that is out of proportion to the skin findings at the initial site of infection that is rapidly followed by tissue necrosis
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Treatment
If unknown aetiology (type 1) - broad spectrum IV antibiotics with the inclusion of IV metronidazole
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Aggressive and prompt antibiotics for confirmed group A streptococci (type 2) - IV benzylpenicillin & IV clindamycin