Necrotizing fasciitis (NF) is a rare and rapidly progressing skin disease caused by a bacterial infection. It affects the subcutaneous cellular tissue and superficial fascia (type of fibrous connective tissue which surrounds muscles, blood vessels and nerves in the body) causing necrosis of the tissue. [1]
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Figure 1 A. Medical illustration depicting normal epidermal, dermal and subcutaneous anatomy. B. Medical illustration of advanced necrotizing fasciitis with necrosis of skin, vascular thrombosis and involvement of underlying muscle. Source: Musculoskeletal Illustrations, Frank Corl [2]
Disease symptoms & Diagnosis
The disease symptoms include small, red and painful lumps on the skin which rapidly turn into painful bruise-like areas …show more content…
[11]
Another way of checking for symptoms of NF infection is through a finger test where a small incision is made in the deep fascia under local anesthesia. Lack of bleeding, presence of characteristic dishwater pus, and lack of tissue resistance to the blunt finger are also considered as symptoms of NF. [7] As all these symptoms can be very nonspecific and the incidence of disease is very infrequent, diagnosing the disease can be complicated. Although, based on the physical appearance of the symptoms observed and patient’s history a preliminary diagnosis is usually made. Radiological imaging and computed tomography (CT) imaging usually shows subcutaneous and deep fascial gas or edema, inflammatory changes, or thickening of fascia or abscesses. [13]
As most of the clinical symptoms are manifested only at a later stage of infection, laboratory analysis is carried out to find the symptoms in the blood through which the disease can be identified. Based on the infected patient’s blood work, the following symptoms or risk indicators can be seen (Table 2). Table 2: Laboratory Risk Indicator for Necrotizing fasciitis score chart [4,