AU - Shivalingappa, Shanthakumar AU - Manjunath, KN AU - Waiker, Veena AU - Kumaraswamy, M AU - Odeyar, Udayashankar TI - Necrotising Fasciitis: Appearances Can Be Deceptive PT - JOURNAL ARTICLE TA - World-J-Plast-Surg JN - World-J-Plast-Surg VO - 10 VI - 1 IP - 1 4099 - http://wjps.ir/article-1-528-en.html 4100 - http://wjps.ir/article-1-528-en.pdf SO - World-J-Plast-Surg 1 ABĀ  - BACKGROUND Necrotizing fasciitis is a potentially fatal infection of β hemolytic Group-A Streptococcus, often occurring in patients with other comorbidities, but can occur in healthy individuals as well. It commonly affects the extremities, perineum, and abdominal wall. The aim of this study was to highlight various presentations of necrotizing fasciitis in unusual anatomical sites with delayed diagnosis and treatment. METHODS In a retrospective analysis, seven cases of unusual presentations of necrotizing fasciitis were enrolled during a period of five years treated in a tertiary center. RESULTS The patients were between 23 and 80 years. Four were males and three were females. Four out of seven were diabetic. All patients had septicemia (hypovolemic shock, with leucocytosis, thrombocytopenia and deranged coagulation parameters) on admission in the intensive care unit. All seven patients had minimal cutaneous manifestation and the remote primary pathology was diagnosed in two patients. Six patients out of seven survived and the morbid state continued in one patient in view of malignancy of rectum in one patient. The overall outcome was satisfactory in five out of seven cases. CONCLUSION Pain disproportionate to the local inflammation with florid constitutional symptoms should raise suspicion of necrotizing fasciitis. Early diagnosis, of stabilization of hemodynamics, emergency fasciotomy, staged debridement and the initiation of broad spectrum antibiotics reduced the morbidity and mortality. The disease may manifest with uncommon presentations and sometimes lead to the diagnosis of primary aetiology. CP - IRAN IN - #790, AVANIKA, 17F2 MAIN, Koramangala 6th block LG - eng PB - World-J-Plast-Surg PG - 43 PT - Original Article YR - 2021