Necrotising fasciitis

Rapidly progressive soft tissue infection characterised by necrosis of subcutaneous tissue

High mortality

Causative organism

Group A streptococcus

1. Aureus, anaerobes

Clinical features

Severe pain at the site of infection

Rapid progression of the infection

Marked systemic features (e.g. high fever with rigors, tachycardia, tachypnoea, hypotension, confusion, vomiting)

Management

Vancomycin and Meropenem 20 mg/kg IV (max 1 g) 8H

AND

Clindamycin 10 mg/kg (max 600 mg) IV 6H

Urgent referral to surgical team for debridement