Early diagnosis and treatment of necrotizing fasciitis

Necrotizing fasciitis (NF) is a rapidly progressive and life-threatening infection, primarily involving the fascia and subcutaneous tissue. Early recognition and aggressive debridement of all necrotic tissue is a major prognostic determinant, and delays in operative debridement have been shown to increase the associated mortality rate. However, it is difficult to clinically recognize NF early in its evolution, because the disease is often indistinguishable from cellulitis or erysipelas. Once NF is strongly suspected, immediate surgical intervention should be considered, along with the administration of broad-spectrum antibiotics and general supportive measures. In this review, we provide a broad description of the clinical characteristics of NF, and its early points of recognition, surgical approach, and overall management.