Don't get hung up on subcutaneous gas and late findings of necrotizing fasciitis (e.g., bullae, necrosis). Pain out of proportion to exam is usually the key early finding - Josh Farkas


image by: Tulane University Preventive Medicine Residency Program

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Necrotizing Fasciitis

There is no set of clinical findings, lab test results and even imaging that can definitively rule out necrotizing fasciitis – an infection of the deep soft tissues that rapidly spreads along fascial planes and carries a mortality of 30-40%, even with therapy. If you have anything more than the slightest suspicion based on your clinical exam, consider early consultation with a plastic surgeon and start empiric antibiotics. While lab findings and imaging findings can be supportive of the diagnosis, negative lab and imaging studies cannot rule out necrotizing fasciitis and should never override clinical judgment. When lab tests and imaging are noncontributory, the diagnosis can only be made…

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Last Updated : Monday, October 25, 2021