Necrotising fasciitis was first described in 1952. There are three different types of necrotising fasciitis.
Type 1 necrotising fasciitis
Type 1 necrotising fasciitis tends to occur in patients with diabetes, who are immunosuppressed or as a post-operative infection.
Necrotising fasciitis type 1 is a polymicrobial infection which is caused by a mixture of anaerobic bacteria and facultative aerobic cocci and organisms such as E coli. The condition is a soft tissue infection and the tissue damage and toxicity are caused due to the release of exotoxins from bacteria, and cytokines from white blood cells.
Type 2 and Type 3 necrotising fasciitis
Type 2 necrotising faciitis is caused by the Streptoccocus bacteria. Type 3 is caused by the Clostridium bacteria and is often referred to as type 3 gas gangrene as gas is regularly found in the tissues.
Necrotising fasciitis presentation
A patient who presents with necrotising fasciitis normally presents with clinical features similar to cellulitis, including erythema (red skin), swelling and heat in the infected area. As mentioned above the patient is often immunosuppressed or diabetic. However, this is not always that case as necrotising fasciitis can affect anyone of any age.
If left untreated the skin becomes shiny and extremely tender. If the bacteria get into the bloodstream a patient will develop septicaemia (i.e. an infection of the blood). This will lead to septic shock, tachycardia (fast heart rate), hypotension (low blood pressure), confusion and a raised white blood cell count.
Untreated the condition is fatal, and around 30% of patients who develop necrotising fasciitis will not survive.
Failure to diagnose necrotising fasciitis
There is no doubt that a diagnosis is difficult and does depend upon a high index of suspicion in the clinical setting. Once diagnosed – which can only really be achieved by means of surgical exploration – the treatment is by radical surgical debridement. All necrotic tissue needs to be removed, fascial planes drained and, if the muscles are involved, a fasciotomy performed. It is mandatory to undertake repeat procedures as the infection can spread rapidly.
If a patient is displaying all the classical features of necrotising fasciitis but there is still a significant delay in medical management, medical practitioners will not have provided an acceptable standard of care.
Have you suffered a delay in treatment?
If you have suffered due to a delay in necrotising fasciitis treatment, you could be entitled to pursue a claim. Contact us today for more information.
Free, No Obligation Enquiry
Call us now on 0800 234 3300 (or from a mobile 01275 334030) or complete our Free Online Enquiry.
