Necrotising Fasciitis From Septic Arthritis
Necrotising fasciitis is a severe bacterial infection that kills the soft tissues. It can occur as a result of another infection, such as septic arthritis or an abscess.
Septic arthritis is when an infection develops in a joint. An abscess is pus-filled cavity underneath the skin or inside the body.
Recognising septic arthritis
When a patient presents with a very high fever is association with orthopaedic pain (i.e. movement-related), a doctor must consider an urgent infective orthopaedic cause.
The attending clincian must act quickly because joint pain in the presence of fever is an orthopaedic emergency that requires the patient to be admitted to hospital to exclude the possibility of septic arthritis.
If there is a fever with lower back pain, these should be viewed as a red flag warning for spinal abscess mandating investigation but not necessarily same-day investigation.
What action is required?
The combination of fever and severe orthopaedic pain suggests a serious infective cause such as septic arthritis or abscess. In such cases, other investigations such as a full blood count, white cell count and C-Reactive Protein should all be undertaken under a referral made to the orthopaedic or A&E team.
Failure to diagnose and treat septic arthritis
Severe orthopaedic pain in the presence of a fever must be considered to have an infective cause and requires urgent investigation and diagnosis. Hospital referral or urgent blood tests followed by hospital admission that day should follow.
If a medical practitioner fails to achieve this standard of care, the standard of care could be deemed negligent. For example is there is a failure to undertake the necessary tests, such as taking the patient's temperature, there will be obvious negligence in failing to act and consider the diagnosis.
It may also amount to negligence if a medical practitioner fails to order a blood test, fails to interpret the blood test accurately, fails to refer a patient to hospital, fails to verify a diagnosis in hospital, and fails to offer emergency treatment.
Making a medical negligence claim
When a patient presents with severe pain and fever, all responsible practitioners would be concerned that the diagnosis was probably infective and would undertake blood tests to be available later that day, or would send a patient to hospital for further investigation that day as a case of high unexplained fever and orthopaedic pain. In hospital, additional tests and surgery should confirm septic arthritis or abscess.
If there is a failure to diagnose and treat septic arthritis or an abscess in time, allowing necrotising fasciitis to develop, there could be grounds for a medical negligence claim. Contact us today for more information.
Legal advice
For more information on necrotizing fasciitis medical negligence, please get in touch with us today.
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