From the Guidelines
The most sure sign of necrotising soft tissue infection is the presence of skin necrosis with easy dissection along the fascia by a blunt instrument, or the presence of gas in the soft tissues, as these signs indicate severe tissue damage and are highly suggestive of necrotizing fasciitis. According to the 2014 update by the Infectious Diseases Society of America 1, features suggestive of necrotizing fasciitis include skin necrosis, gas in the soft tissues, and other signs of severe infection. While grayish brown discharge from the wound, fever, and soft tissue infection, as well as redness, pain, pitting edema with fever, may be present in necrotising infections, they are not as specific or reliable as the presence of skin necrosis or gas in the soft tissues. The presence of these signs indicates a high risk of severe complications and necessitates immediate surgical intervention and broad-spectrum antibiotic therapy.
Some key features of necrotizing fasciitis include:
- Skin necrosis with easy dissection along the fascia by a blunt instrument
- Presence of gas in the soft tissues
- Profound toxicity, including fever, hypotension, or advancement of the soft tissue infection during antibiotic therapy
- Failure of apparently uncomplicated cellulitis to respond to antibiotics after a reasonable trial.
It is essential to recognize these signs early, as necrotizing soft tissue infections can progress rapidly and require prompt treatment to prevent life-threatening complications, as emphasized in the guidelines 1.
From the Research
Signs of Necrotising Soft Tissue Infection
- The most sure sign of necrotising soft tissue infection is not explicitly stated in the provided studies, but common signs and symptoms include:
Diagnostic Challenges
- Necrotising soft tissue infections can have a deceptively innocent early clinical presentation, making diagnosis challenging 5
- Delays in diagnosis and treatment can lead to increased morbidity and mortality 4, 5, 6