Necrotising fasciitis can be difficult to diagnose in the early stages as it can resemble cellulitis, which is a bacterial infection of the skin and the tissues beneath it.
Signs of cellulitis
Cellulitis is most commonly caused by streptococci bacteria, which enter the skin via a wound. The affected area is hot, tender, swollen and red, and there may be fever and chills.
Untreated cellulitis at the site of a wound may progress to bacteraemia and septicaemia or, occasionally, to gangrene. Cellulitis is usually more severe in people with reduced immune response, such as those with type II diabetes or an immunodeficiency disorder.
Signs of necrotising fasciitis
In necrotising fasciitis, the affected area is also hot, tender, swollen and red. There will also be fever and chills. These symptoms mirror those of cellulitis.
However, the progressive changes of the skin will differ. Necrotising fasciitis usually involves the formation of bullae (thin walled blisters), ulceration of the skin and black scabs. There is also heavy leakage of tissue fluid from the affected area and bubbles of gas in the tissues.
Correct diagnosis of necrotising fasciitis
Therefore necrotising fasciitis does mimic cellulitis in the early stages, and medical practitioners may be forgiven for initially making a misdiagnosis.
Nevertheless, the necrotising fasciitis infection will quickly progress and the visual appearance of the skin will rapidly change. These visual indicators should prompt medical practitioners to veer away from the suspected diagnosis of cellulitis and investigate other potential causes. Blood cultures and swabs should be carried out, and these will confirm the presence of necrotising fasciitis, rather than cellulitis.
Missed diagnosis of necrotising fasciitis
If medical practitioners fail to recognise the signs of necrotising fasciitis, instead sticking with the original diagnosis of cellulitis, the standard of care must be called into question.
It is not unreasonable for such a mistake to be made in the early stages, but as soon as the skin begins to discolour, an initial diagnosis of cellulitis should be re-examined. This is because these symptoms do not tally with cellulitis and it should be evident to medical practitioners that another condition is present.
If there is a failure to recognise the signs and symptoms of necrotising fasciitis, leading to a delayed diagnosis, there may be a case of medical negligence.
Claiming for necrotising fasciitis
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