Necrotising fasciitis and traditional medical therapy-- a dangerous liaison

ABSTRACT

<p><b>INTRODUCTION</b>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.</p><p><b>CLINICAL PICTURE</b>Both presented with pain, swelling, bruising or necrosis of the affected extremities. Traditional medical therapy was sought prior to their presentation.</p><p><b>TREATMENT</b>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.</p><p><b>OUTCOME</b>The first patient survived, while the second died.</p><p><b>CONCLUSION</b>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.</p>