Table 3

Clinical features suggestive of necrotizing soft tissue infections

SKINPAINGENERAL
Erythema with ill-defined marginsPain that extends past margin of apparent infectionFever with toxic appearance
Tense edema with grayish or brown dischargeSevere pain that appears disproportionate to physical findingsAltered mental state
Lack of lymphangitis or lymphadenopathyDecreased pain or anesthesia at apparent site of infectionTachycardia
Vesicles or bullae, hemorrhagic bullaeTachypnea due to acidosis
NecrosisPresentation with DKA or HHNK
Crepitus
  • DKA—diabetic ketoacidosis, HHNK—hyperosmolar hyperglycemic non-ketotic acidosis.

  • Data from Seal,14 Green et al,22 Headley,23 Hsiao et al,24 Elliot et al,25 and Dufel and Martino.26