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Diagnosing necrotising fasciitis
When necrotising fasciitis first develops, it will produce the following symptoms:
- A severe localised pain
- Fever
- Skin that is red and hot to touch
These symptoms are typical of a bacterial infection and should immediately prompt doctors to suspect the possibility of necrotising fasciitis. Steps should then be taken to confirm whether this suspected diagnosis is correct.
To verify a diagnosis, medical practitioners should:
1. Perform blood tests to look for signs of infection
2. Take a tissue culture/tissue biopsy and send it to the laboratory for testing
3. Carry out imaging tests – such as an MRI scan – to identify fluid, gas and inflammation in the tissue
With these tests, it should be possible to make an accurate diagnosis of necrotising fasciitis, and determine the type of bacteria causing the infection.
However, if a patient is already very unwell at the time of presentation, necrotising fasciitis may be diagnosed upon symptoms alone. If carrying out further tests would cause a dangerous delay, doctors should simply proceed to surgery.
Missed diagnosis of necrotising fasciitis
Unfortunately medical professionals do not always manage to make an accurate diagnosis, instead mistaking necrotising fasciitis for another condition entirely. The most common misdiagnosis is cellulitis, an infection of the deeper layers of skin.
Cellulitis has very similar symptoms to necrotising fasciitis, but there are key differences between the two. For example, a patient’s white blood cell count will be much higher with necrotising fasciitis. There will also be crepitus (crackling of the skin), intense pain and an increased heart rate. Therefore it should be possible to avoid a misdiagnosis.
Consequences of a delayed diagnosis
If necrotising fasciitis is wrongfully diagnosed the results will be devastating, as treatment will be significantly delayed. Often it is only when a patient’s health deteriorates that the condition is finally detected. By that stage the area of infection will be extensive and serious complications may ensue.
If a delayed diagnosis does cause a patient further pain and suffering, there could be grounds for a compensation claim. This is because any reasonably competent medical practitioner should be able to diagnose necrotising fasciitis; a failure to do so will be considered negligent.
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