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Necrotising Fasciitis — SCE Infectious Diseases MCQ

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HardHealthcare-Associated InfectionsNecrotising FasciitisSCE Infectious Diseases

A patient with group A streptococcal limb infection develops pain out of proportion, bullae, crepitus and rapidly advancing necrosis despite antibiotics. What action most affects survival?

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Correct answer: C — Arrange immediate surgical exploration and radical debridement while continuing broad antimicrobial and organ-support therapy

The best answer is “Arrange immediate surgical exploration and radical debridement while continuing broad antimicrobial and organ-support therapy”. Necrotising soft-tissue infection is a surgical emergency; imaging or antimicrobial adjustment must not delay definitive source control. “Increase benzylpenicillin and observe for another 12 hours” does not match the decisive clinical feature or cited guidance. “Obtain contrast CT before contacting surgery” does not match the decisive clinical feature or cited guidance. “Switch antibiotics without source control” does not match the decisive clinical feature or cited guidance. “Use hyperbaric oxygen as a substitute for debridement” does not match the decisive clinical feature or cited guidance.

Reference: NICE NG141 cellulitis and erysipelas recommendations: https://www.nice.org.uk/guidance/ng141/chapter/Recommendations