Sat27November0445PM 5

In patients with necrotising fasciitis:

True / False

A single organism is normally responsible Correct

The trunk and perineum are most frequently involved Correct

Lymphangitis is common Incorrect answer selected

Blistering is rare Correct

Subcutaneous fat and deep fascia are spared Correct

Explanation

Necrotising fasciitis (NF) is normally due to a combination of different organisms.

Type I NF occurs in up to 80% of cases and is usually due to a combination of Gram positive cocci, Gram negative rods and anaerobes (that is, polymicrobial).

Type II NF is monomicrobial. It normally begins in the subcutaneous fat and deep fascia, unlike cellulitis that originates in the dermis and superficial fascia.

Blistering is rare in cellulitis, however it is a common, albeit late, finding in NF.

Lymphangitis is rare.

Reference:

Davoudian P, Flint NJ. Necrotising Fasciitis. Contin Educ Anaesth Crit Care Pain. 2012;12:245-250.

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