Diagnosing necrotising skin and soft tissue infections

A number of clinical syndromes can be associated with rapidly progressive necrotising skin and soft tissue infections, such as necrotising fasciitis (necrosis of the soft tissues), myonecrosis (necrosis of the muscles) or gangrene (extensive necrosis). Diagnosis is difficult – see Presentation of necrotising skin and soft tissue infections and seek expert advice.

Note: Diagnosis of necrotising skin and soft tissue infections is difficult. Expert advice is essential.

Consider necrotising skin and soft tissue infections in patients who are critically ill with a skin and soft tissue infection.

Note: Consider necrotising infection in patients who are critically ill with a skin and soft tissue infection.

If the diagnosis is uncertain, early surgical consultation is recommended; surgical exploration and collection of deep tissue samples for microscopy and culture can provide a definitive diagnosis.