title: Necrotising fasciitis and traditional medical therapy-- a dangerous liaison.
abstract: 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.
authors.affiliation: Department of Hand Surgery, Singapore General Hospital, Singapore. lim.yi.jia@singhealth.com.sg
authors.forename: Yi-Jia
authors.initials: YJ
authors.lastname: Lim
authors.forename: Fok-Chuan
authors.initials: FC
authors.lastname: Yong
authors.forename: Chin-Ho
authors.initials: CH
authors.lastname: Wong
authors.forename: Agnes B H
authors.initials: AB
authors.lastname: Tan
mesh_terms: 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