Necrotising fasciitis is an illness which can go from a small cut to organ failure and death in a matter of days. Rapid diagnosis and comprehensive treatment are vital to a patient’s survival.
Diagnosis of necrotising fasciitis
Necrotising fasciitis is a rare condition which can be confused with other illnesses in its early stages.
The typical early symptoms of necrotising fasciitis include an opening in the skin, such as a cut, graze, injection site or surgical incision, accompanied with intense pain, redness, tenderness and swelling in that region.
However, an open wound is not always present and the remaining symptoms can be misdiagnosed as a number of other conditions such as the following:
- Cellulitis – a bacterial skin infection
- Deep vein thrombosis – a blood clot in the vein, usually in a leg
- Sciatica – pain due to compression of the sciatic nerve in the lower back
- A haematoma – blood clot outside the blood vessels due to trauma or injury
- Septic arthritis – inflammation of a joint due to an infection
However, where a patient attends their GP with the above symptoms alongside a high temperature and a fast heartbeat, it should be considered that a more sinister condition may be developing and that further investigation is necessary.
Delayed diagnosis
A delay in diagnosing necrotising fasciitis can lead to tragic outcomes and any suspicion that a patient may be exhibiting the early symptoms should warrant a referral for investigation without delay.
A delay in diagnosis will, inevitably result in a delay in treatment and the passage of time will allow the development of the condition and the deterioration of the patient’s health and chances of survival.
Treatment of necrotising fasciitis
Once a diagnosis of necrotising fasciitis has been made, or even when there is strong suspicion, treatment is a matter of emergency.
Necrotising fasciitis has a very high associated mortality rate of up to 40% even with treatment and so any delay can prove fatal.
Patients who appear to be developing necrotising fasciitis are likely to require intravenous antibiotics, surgical treatment and intensive care support.
Surgical debridement
- Necrotising fasciitis will destroy the tissue it encounters as it spreads through the body’s deep soft tissue, so all infected tissue needs to be surgically removed as soon as possible to halt the spread of the disease
- The emphasis, however, is not simply on speed of management but also on the extent of debridement. It is imperative that ALL infected tissue is removed otherwise the disease will continue to spread. If early surgery is not comprehensive, the patient will need to undergo further debridement procedures until such time as all infected tissue has been removed. This may require as many as five or six surgical operations before the disease is fully removed from the body.
Delayed treatment
A delay in the initiation of treatment can have catastrophic outcomes:
- If the infection continues to spread due to delayed treatment or insufficiently-comprehensive treatment, the patient may require a limb to be amputated in order to stop the spread of gangrene
- A delay in treatment is likely to mean that the patient will require more surgical procedures , a longer stay in both hospital and intensive care, and suffer greater long-term effects
- If treatment is delayed for too long, the patient’s chances of survival are adversely affected
Medical Negligence
The impact of necrotising fasciitis is so severe, that any suspicion of the presence of this infection needs to be acted upon immediately.
Where a patient is exhibiting symptoms of necrotising fasciitis but action and diagnosis are delayed, it may be appropriate to make a claim for compensation.
Patients who are already in hospital undergoing surgical procedures are at a greater risk of developing necrotising fasciitis and signs of infection in these patients warrant immediate referral.
If you or a loved one are suffering the appalling impact of necrotising fasciitis due to a delay in diagnosis, contact us to discuss your experience with a specialist medical negligence solicitor.
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