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EMU 365: Best Emergency Medicine Articles of the Year 2018

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miércoles, 18 de octubre de 2017

Necrotizing fascitis

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."