IBCC Episode 118 - Necrotising Fasciitis

In this episode of The Internet Book of Critical Care Podcast, Josh and Adam discuss necrotizing fasciitis, emphasizing its challenging diagnosis and potentially rapid progression. They cover the classification of necrotizing fasciitis into types 1, 2, and 3, focusing on the clinical presentation, early findings like pain out of proportion to the exam, and the importance of a high index of suspicion. The hosts discuss the limitations of relying solely on labs and imaging, advocate for bedside surgical exploration when appropriate, and detail antibiotic management, including the use of clindamycin, broad-spectrum beta-lactams, and linazolid. They also touch on adjuvant therapies like IVIG for toxic shock syndrome and hyperbaric oxygen for clostridial infections, while stressing the importance of early surgical debridement and source control.