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Necrotising fasciitis and traditional medical therapy-- a dangerous liaison
Yi-Jia Lim1, Fok-Chuan Yong, Chin-Ho Wong
1Department of Hand Surgery, Singapore General Hospital, Singapore. lim.yi.jia@singhealth.com.sg
Introduction:
Necrotising fasciitis is a disease associated with high morbidity and mortality, and multi-focal necrotising fasciitis is uncommon. We present 2 cases of concurrent necrotising fasciitis of contralateral upper and lower limbs.
Clinical Picture:
Both presented with pain, swelling, bruising or necrosis of the affected extremities. Traditional medical therapy was sought prior to their presentation.
Treatment:
After initial debridement, one patient subsequently underwent amputation of the contralateral forearm and leg. The other underwent a forearm amputation, but refused a below-knee amputation.
Outcome:
The first patient survived, while the second died.
Conclusion:
Traditional medical therapy can cause bacterial inoculation, leading to necrotising fasciitis, and also leads to delay in appropriate treatment. Radical surgery is needed to optimise patient survival.
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