Misdiagnosing Necrotising Fasciitis
Necrotising fasciitis is a fast-moving infection of the deep, soft tissue, which destroys the tissue it affects. At best, it can be distressingly damaging to the victim's body. At worst, it can be fatal. Accurate diagnosis is essential.
Necrotising Fasciitis
Necrotising fasciitis is not a common condition – only approximately 500 cases per year are thought to occur in the UK – but up to 40% of people who develop it, are likely to die of it.
The patient can deteriorate from initial symptoms to multiple organ failure and death in just a few days. Therefore, it is vital that the illness is diagnosed promptly and treated as an emergency in order to improve the chances of patient survival.
The problem is that necrotising fasciitis can be confused with other conditions and, as we have seen, any delay in diagnosis can be life-threatening.
What are the symptoms of necrotising fasciitis?
The symptoms of necrotising fasciitis are redness and swelling of the skin with disproportionate pain in the affected area. There may be evidence of a cut or wound to the skin where the bacteria causing the infection have entered the body.
It is also likely that the patient will also be displaying flu-like symptoms such as a fever, nausea and vomiting.
The condition tends to occur predominantly in the abdominal or genital area, but is also known to occur in the extremities.
If necrotising fasciitis is diagnosed, the patient needs intravenous antibiotics and surgical debridement (removal) of all affected tissue urgently to prevent the infection from spreading.
Confusing necrotising fasciitis with Deep Vein Thrombosis
Unfortunately, it is possible to misdiagnose necrotising fasciitis as Deep Vein Thrombosis. DVT – a blood clot, usually in the leg - is a far more common condition, affecting approximately 1 in 1000 people in the UK every year.
There are similarities in the key symptoms such as pain, swelling and tenderness, usually in the leg, along with warm, red skin. A GP is likely to be far more familiar with the symptoms of DVT and may, therefore, identify the cause of the symptoms incorrectly.
However, it is less likely that a patient with DVT will be showing other symptoms such as nausea and vomiting or a temperature. These are warning signs that should alert a GP to the likelihood that an infection is present.
Unlike necrotising fasciitis, deep vein thrombosis can be treated at home with anticoagulant medication to prevent the blood from clotting.
Occasionally, it can lead to more severe complications, but is not necessarily a medical emergency. Whereas necrotising fasciitis most certainly is.
Confusing necrotising fasciitis with cellulitis
It is also possible to confuse necrotising fasciitis with cellulitis. Cellulitis is another infection but this time affects the deep layers of the skin rather than the deeper tissue layers. Like necrotising fasciitis, cellulitis exhibits the following symptoms:
- Pain and tenderness in the affected area
- Redness, inflammation or swelling of the skin
- Warmth of the skin in the affected area
It is also a condition which can often occur in the legs and it is understandable that it might be confused with necrotising fasciitis.
Like necrotising fasciitis, it can be a life-threatening condition but there is a far greater chance of survival and the infection can be successfully treated with antibiotics.
Cellulitis might be accompanied by a rash or abscess and the skin may have a glossy appearance. Where a GP is uncertain of the diagnosis, and there may be alternative interpretations of the symptoms being exhibited by the patient, a second opinion should be sought or the patient sent for further investigations.
Responding to necrotising fasciitis symptoms
Given the similarity of some symptoms, extreme caution should be exercised to ensure that necrotising fasciitis is not overlooked.
- If flu-like symptoms are present, the patient may not suffering from Deep Vein Thrombosis
- If flu-like symptoms are present, the patient may be suffering from an infection
- If there is any uncertainty, a second opinion should be sought
- If diagnosis is unclear, a referral for further investigation would be better than a misdiagnosis
- Surgical investigation may be necessary and this is sometimes the only way that necrotising fasciitis is conclusively diagnosed.
Medical Negligence
Where diagnosis is unclear and the medical practitioner has neither sought a second opinion, nor referred the patient for further investigation, leading to an inaccurate diagnosis and inappropriate treatment, the practitioner may be guilty of medical negligence. The patient may be entitled to make a claim for compensation for the pain and suffering caused.
If you or a loved one have suffered the devastating consequences of a failure to diagnose and treat necrotising fasciitis, contact Glynns Solicitors to discuss your situation with a solicitor.
We are a team of solicitors specialising in medical negligence, with considerable experience of supporting victims of a failure to diagnose and treat necrotising fasciitis.
Please call us free on 0800 234 3300 (or from a mobile 01275 334030) or complete our Online Enquiry Form.
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