P. Banan , S. Kazemian Marvi
A 52 year old male presented to hospital with a 24 hour
history of lower abdominal pain. On initial assessments, he
was systemically unwell but with just minimal supra pubic
erythema. Based on symptoms and observation readings, he
was started on intravenous ﬂ uids and antibiotics with an
impression of cellulitis. Progressive skin manifestations, a
poor response to antibiotic treatment and signs of systemic
involvement raised the possibility of necrotizing fasciitis.
Surgical exploration and further pathology investigations
conﬁ rmed the diagnosis.
Necrotising fasciitis is an uncommon but potentially lethal
condition which can be difﬁ cult to diagnose at times.
Patients are usually systemically unwell and can deteriorate
within hours. A high index of suspicion and a low threshold
to seek surgical attention ultimately may allow for earlier
diagnosis and treatment of this condition. Aggressive surgical
debridement and intravenous antibiotic therapy are the
key points to treatment. Antibiotic therapy alone has mortality
rate of about 100%.