Necrotising soft-tissue infections are a range of destructive and swift-moving conditions that destroy the body’s tissue and threaten the life of the patient.
NSTIs
Including necrotising fasciitis and necrotising myositis, amongst others, necrotising soft-tissue infections are, thankfully, fairly rare conditions. However, the fact that many medical practitioners may never encounter these infections means that their diagnosis can be delayed due to unfamiliarity with the condition.
A delay in diagnosis inevitably leads to a delay in treatment which, in the case of these virulent infections, can prove fatal to the patient.
Both forms of the illness can be confused with, and are often diagnosed as, cellulitis which is a common bacterial skin infection, presenting with redness, swelling and tenderness of the skin.
Necrotising fasciitis
A patient who is developing necrotising fasciitis may present with precisely these symptoms.
They may additionally have a cut to the skin, such as a graze, injection site or surgical incision, which has allowed bacteria to enter the deep soft tissue layers of the body.
Symptoms which might suggest that the patient, in fact, has necrotising fasciitis are the sensation of intense and disproportionate pain alongside flu-like symptoms such as a high temperature and fast heartbeat.
Patients at risk
Some groups of patients are more susceptible to developing soft-tissue infections and medical practitioners should have a high level of suspicion when a patient from one of these groups presents with the above symptoms. Such groups would include the following:
- Patients suffering from diabetes
- Patients who are obese
- Patients with liver problems or high alcohol intake
- Patients with chronic heart failure
- Patients suffering with a weakened immune system
Additionally, patients who are already in hospital undergoing surgery – and, therefore, experiencing a surgical cut to the skin – are more susceptible to the invasion of bacteria and the subsequent development of infection.
Emergency treatment
A necrotising soft-tissue infection is a medical emergency. The patient is likely to require intravenous antibiotics and debridement surgery.
Any delay will allow the infection to spread and further areas of tissue to become infected. The greater the extent of infection, the more tissue will need to be surgically removed before the infection is halted and the more damaging the long-term impact on the patient. It may even be necessary to amputate one or more limbs, a key area of infection for necrotising infections, before the infection is removed.
Research
Necrotising soft-tissue infections have a high mortality rate due both to the nature of the destruction they can cause to the body’s organs as well as the speed with which they can spread through the body.
The treatment for these infections can also be highly damaging to the body as all infected tissue must be surgically removed. The patient, if they survive, may require an extended stay in an intensive care unit on life-support before they recover.
The need for greater understanding and rapid diagnosis is, therefore, crucial to improving the survival rate of these debilitating illnesses, and specialists from across the European Union are combining forces in the INFECT project to try to improve knowledge of these infections.
Medical negligence
A failure to diagnose or at least consider the possibility of a soft-tissue infection, particularly in a patient from an at-risk category, may be considered to have been negligent.
If you or a loved one are suffering with the appalling long-term impact of a late diagnosis of necrotising fasciitis, contact us to discuss your experience.
We are a specialist medical negligence practice with considerable expertise in supporting necrotising soft-tissue compensation claims.
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