Clinical Communiqué Volume 12 Issue 1 Winter 2025

Download PDF:  Clinical Communiqué Winter 2025 Edition

In this edition

• Editorial

• Case #1: A diagnostic dilemma

• Case #2: A fulminant fishy tale

• More on the Matter Time is of the essence

• Expert Commentary Racing against necrosis

This edition features the coronial findings of patients who died as a result of overwhelming necrotising fasciitis (also known as necrotising soft tissue infection, NSTI). Common to each of the cases was a delay to diagnosis and a delay to surgical debridement, leading to sepsis and death within a short period of time. NSTI is a difficult diagnosis to make. There is an absence of visible cutaneous signs in the early stages, a lack of gold standard diagnostic testing, and classic systemic features are often absent until the patient’s deterioration is potentially irretrievable. As such, NSTI is a condition that needs to be front of mind for every clinician when signs and symptoms suggesting an infection do not fit with the clinical picture. The expert commentary by colorectal and general surgeon Dr Danette Wright, highlights the diagnostic challenges and management principles for NSTI and is a valuable guide for all clinicians to heed, to prevent morbidity and mortality from this debilitating condition.