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Medical Author:

Steven Doerr, MD

Steven Doerr, MD

Steven Doerr, MD, is a U.S. board-certified Emergency Medicine Physician. Dr. Doerr received his undergraduate degree in Spanish from the University of Colorado at Boulder. He graduated with his Medical Degree from the University Of Colorado Health Sciences Center in Denver, Colorado in 1998 and completed his residency training in Emergency Medicine from Denver Health Medical Center in Denver, Colorado in 2002, where he also served as Chief Resident.

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Medical Editor:

Charles Patrick Davis, MD, PhD

Charles Patrick Davis, MD, PhD

Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

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The diagnosis of necrotizing fasciitis is often presumptively made initially based on the patient's history and physical examination findings. Though there are several laboratory tests and imaging studies that may assist in making the diagnosis of necrotizing fasciitis, immediate results may not be readily available. Therefore, a high index of suspicion in any patient with symptoms or signs suggestive of necrotizing fasciitis should prompt immediate consultation with a surgeon in order to expedite management.

• Laboratory testing will include various blood tests such as a complete blood count (CBC), which may reveal an elevated white blood cell count (WBC). Electrolyte panels, blood cultures, and other blood tests are also generally obtained. However, the results of these blood tests cannot be solely relied upon to make an immediate diagnosis.
• Imaging studies such a CT scanning, MRI, and ultrasound have all been used successfully to identify cases of necrotizing fasciitis. They may be used when signs are equivocal or the diagnosis is in doubt. These modalities may help identify areas of fluid collections, inflammation and gas within the soft tissue, in addition to helping delineate the extent of the infection. Although occasionally plain radiographs (X-rays) may demonstrate gas in the soft tissue, they are considered less useful and of little value. Obtaining imaging studies should not delay definitive treatment in those cases highly suggestive of necrotizing fasciitis.
• Tissue culture, tissue biopsy, and Gram stain results can help definitively identify the organism(s) responsible for the infection, and this can help guide appropriate antibiotic therapy.

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