Suspected Necrotizing SSTI

• Pain out of proportion to clinical findings

• Rapid progression

• Gas in tissues/crepitus (on exam or imaging)

• Overlying tissue necrosis

• Reduced sensation over affected area

• Severe sepsis/septic shock

Obtain blood cultures x 2 sets and CK level in addition to other routine labs.

Imaging does not rule out the diagnosis of a necrotizing infection.

If suspected necrotizing fasciitis, need deep tissue specimen for C&S.

Surgical debridement is critical in cases of necrotizing fasciitis.

Clinically one cannot reliably distinguish between necrotizing cellulitis, fasciitis, or myonecrosis.