What Are the Clinical Features of Necrotizing Fasciitis?
Necrotizing fasciitis is an infectious disease that can occur in any part of the body. However, studies show that it is more likely to occur in the extremities, especially the legs. It usually starts with pain in the affected part of the body followed by various signs, such as:
- Swelling
- Erythema [1]
- Tenderness
- Heat
The pain that accompanies the signs of necrotizing fasciitis are usually more severe than the signs of the normal skin infection. Many doctors tend to underestimate the severity of tissue affected because the infection may spread within subcutaneous tissue while relatively sparing the overlying skin tissue and it is not usually accompanied by lymphangitis and lymphadenitis.
Necrotizing fasciitis is usually accompanied by a swelling that worsens to brawny edema and induration. After 2 days, the overlying skin starts to turn dusky because the small vessels located in the papilla of the dermis form clots. In severe cases, cutaneous ischemia may occur due to the absence of blood flow to the skin. Bullae may develop and become filled with straw colored fluid that worsen to become hemorrhagic fluid. Infected skin darkens over time moving from red to purple to blue. Gangrene starts to develop and the skin becomes anesthetized due to death of the superficial nerves
Severe cases of necrotizing fasciitis are usually accompanied by certain signs, such as:
- Necrosis [2]
- Bullae
- Crepitus
- Anesthesia
- Ecchymosis [3]