16th July 2026

Necrotising Fasciitis

Necrotising fasciitis is a rapidly progressing infection of the fascia and subcutaneous tissues, causing tissue necrosis. It is a surgical emergency with high mortality.

There are two main types:

• Type I (polymicrobial)
• Type II (usually Group A Streptococcus)

Presentation includes extreme pain out of proportion to findings, systemic toxicity, skin discolouration, crepitus, and hypotension.

Diagnosis

CT or MRI may show fascial thickening and gas in soft tissues. Bloods show raised inflammatory markers. Surgical exploration is often diagnostic.

Management

• Urgent surgical debridement
• Broad-spectrum IV antibiotics: meropenem + clindamycin + vancomycin
• Supportive care in ICU if required