Necrotising fasciitis and traditional medical therapy-- a dangerous liaison.
BACKGROUND
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.


METHODS
Both presented with pain, swelling, bruising or necrosis of the affected extremities. Traditional medical therapy was sought prior to their presentation.


METHODS
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.


RESULTS
The first patient survived, while the second died.


CONCLUSIONS
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.
Lim
Yi-Jia
YJ
Department of Hand Surgery, Singapore General Hospital, Singapore. lim.yi.jia@singhealth.com.sg
Yong
Fok-Chuan
FC
Wong
Chin-Ho
CH
Tan
Agnes B H
AB
D000368:Aged; D000671:Amputation, Surgical; D003646:Debridement; D019115:Fasciitis, Necrotizing / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery*; D017809:Fatal Outcome; D005260:Female; D006225:Hand / Q000382:microbiology / Q000601:surgery; D006801:Humans; D007866:Leg / Q000382:microbiology / Q000601:surgery; D008297:Male; D008518:Medicine, East Asian Traditional; D008875:Middle Aged; D012307:Risk Factors