Necrotising fasciitis must be diagnosed and treated without delay. But how is the condition diagnosed? And what treatment is required once it has been diagnosed?
How to diagnose necrotising fasciitis
A preliminary diagnosis of necrotising fasciitis will normally be based upon the patient’s clinical presentation. Often a patient with necrotising fasciitis will present to a medical practitioner or organisation complaining of:
- An intense pain that has no obvious cause
- Fever
- An area of skin that is red and hot to touch
These symptoms should prompt further investigation into the underlying cause. As these symptoms are indicative of an infection, medical practitioners may choose to start a patient on intravenous antibiotics in the meantime.
In order to confirm a diagnosis, it will be necessary to perform a surgical investigation. This will reveal ‘dishwater’ fluids and necrotic tissue. A biopsy of the tissue will help to verify the organism responsible for the infection.
Prior to a surgical investigation, a patient may undergo further tests, including:
- A urine test/blood test, which will show a raised white blood cell count and CRP
- A blood pressure test, which will show low blood pressure
- An ultrasound, CT scan or MRI scan, which will show inflammation and gas in the tissues
By recognising a patient’s symptoms and carrying out prompt investigative tests, medical practitioners should be able to achieve a timely diagnosis.
Delayed diagnosis of necrotising fasciitis
If a diagnosis is not obtained quickly, the patient could come to significant harm. This is because if left untreated, necrotising fasciitis will create an ever-increasing area of necrotic tissue. The infection may also spread to the blood, leading to septic shock and organ failure.
At best, these complications will result in extensive debridement surgery (perhaps involving an amputation) and a period of time in the intensive care unit. At worst, these complications will prove fatal.
If there is a delay in diagnosis, the patient or their family must consider whether an acceptable standard of care was provided. For example, did medical practitioners recognise the symptoms as being indicative of infection? Were prompt diagnostic tests performed? Was treated provided on an emergency basis?
If a substandard level of care was provided, and this caused a patient to suffer harm, there may be grounds for a medical negligence claim.
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