emDocs - October 16, 2017 - Authors: Cohen P and Musisca N
Edited by: Koyfman A and Long B
"Take Home Points
- Necrotizing fasciitis is a challenging diagnosis as it is exceedingly rare and classic findings are often not seen early in the disease.
- Laboratory and imaging data may aid the diagnosis but are often neither sensitive nor specific and should never replace clinical suspicion.
- Early diagnosis is essential but difficult to separate from more common diagnoses such as cellulitis. Key early findings include:
- Tenderness and edema that spreads beyond the apparent boundaries of infection
- Pain out of proportion to skin findings
- Ill-defined margins of involvement
- Rapid progression of infection
- If a patient presents with the classic findings (shock, bullae, crepitus, skin necrosis, and skin anesthesia), the infection has likely progressed and they need prompt surgical consultation."