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Posted on 5/11/18 at 11:44 am to Scruffy
quote:
There isn’t a test for it. It is based on clinical factors/symptoms. The only thing that would ever be done, test-wise, is a culture. There are other labs to perform, and maybe some imaging, but overall, it is a clinical diagnosis based on the person’s presentation. If Scruffy is being honest though, he has never seen or treated a necrotizing fasciitis case. It is fairly rare.
Might have been a silly question, but I gotta ask, right?!? I know it's fairly rare, and your immune system has to be in a certain state, but I also know that it takes very little to get it going, so to speak. That's always kinda frightened me, any time I have a minor cut, etc.
Posted on 5/11/18 at 11:44 am to Scruffy
quote:
The only thing that would ever be done, test-wise, is a culture.
The LRINEC Scoring system is helpful. But I don't wait on results in cases where I suspect nec fasc; drop everything and go straight to the OR.
I've seen it spread from mid calf up to mid thigh in the hour it took between seeing the guy in the ED and getting the case started in the OR.
Posted on 5/11/18 at 11:46 am to DemonKA3268
The doctor probably should have tested it the 2nd time just to be safe and to put them at ease. Better yet, why aren't we testing before handing out antibiotics? Surely everyone would be better off not taking antibiotics unnecessarily and maybe saving a life here and there?
Posted on 5/11/18 at 11:49 am to AUsteriskPride
quote:
The doctor probably should have tested it the 2nd time just to be safe and to put them at ease. Better yet, why aren't we testing before handing out antibiotics? Surely everyone would be better off not taking antibiotics unnecessarily and maybe saving a life here and there?
Gotta be able to drain it to test it.
Also, you gonna pay for a culture? Because I'm sure insurance isn't.
Common things being common, you don't chase zebras in medicine the first go round. You consider it the second time though.
Posted on 5/11/18 at 11:52 am to TDsngumbo
quote:
I'd like a second opinion
You probably have AIDS.
Sorry to be the bearer of bad news.
Get your affairs in order.
RIP baw
Posted on 5/11/18 at 11:59 am to CrimsonTideMD
quote:
You probably have AIDS.
quote:
CrimsonTideMD
That would certainly be a misdiagnosis.
Posted on 5/11/18 at 12:07 pm to htran90
quote:
Also, you gonna pay for a culture? Because I'm sure insurance isn't.
3 doctors visit and a hospital visit later, yeah, I'm sure the doctor could get it covered.
Posted on 5/11/18 at 12:11 pm to DemonKA3268
That stuff gets a few people who get into the Gulf around this time every year.
Posted on 5/11/18 at 12:12 pm to AUsteriskPride
Yeah after the 2nd or even 3rd, but you said before you hand out antibiotics. That's not happening 99/100 times unfortunately.
Posted on 5/11/18 at 12:17 pm to Scruffy
quote:
quote:
Yep, shove some bactroban up your nose for a couple of weeks. See if that helps.
If someone has other tested methods, Scruffy is all ears.
I once instantly cured an incipient cold by accidentally autoclaving my face (including a cloud of vaporized Beaucoup).
I don't recommend this.
Posted on 5/11/18 at 12:18 pm to htran90
quote:
Yeah after the 2nd or even 3rd, but you said before you hand out antibiotics. That's not happening 99/100 times unfortunately.
That's simply not true. My family doctor tests almost always and bcbs gladly pays.
Posted on 5/11/18 at 12:24 pm to Scruffy
Some women are in fact that tough, and continue to do things that would amaze even the best of Dr's.
Posted on 5/11/18 at 1:06 pm to i am dan
quote:
Story didn't say how the bacteria progressed.
No way she died from it just being on her butt I'm assuming. Did it eat away a large portion of her skin or does it go internal?
Yea that didn't make much sense. Usually when it kills it has eaten a large portion of flesh and the person has been in the hospital for days
Posted on 5/11/18 at 1:09 pm to DemonKA3268
Guy I know had their mother die of this. Just completely random and sad.
Posted on 5/11/18 at 1:28 pm to AUsteriskPride
quote:
That's simply not true. My family doctor tests almost always and bcbs gladly pays.
Im going off the thought process this wasn't a quality insurance.
There are some things you just don't need to test to diagnose. Something like that most would think oh its common staph. Seen it a million times. Don't need to culture. Here's antibiotics follow up if it doesn't get better. After the 2nd time though, that's poor form.
Posted on 5/11/18 at 1:34 pm to Eli Goldfinger
quote:
That stuff gets a few people who get into the Gulf around this time every year.
The article only says "necrotizing fasciitis." It doesn't pinpoint the cause. There's no indication it was vibrio vulnificus.
Posted on 5/11/18 at 1:37 pm to htran90
quote:
Im going off the thought process this wasn't a quality insurance.
BCBS is a bitch to deal with. Just because they have 80% of a captive audience doesn't make them great. Their reimbursement rates are barely better than medicaid on many things and they fight claims harder than most.
Posted on 5/11/18 at 2:02 pm to lsupride87
You should probably learn more about standard of care before making statements like these...
The lady came to the doctor for an abscess with likely mild surrounding cellulitis (we see this every day in the ER). The standard of care is incision and drainage or warm compresses if the doctor feels like it will burst on its own +/- antibiotics. Now, unless the lady was septic and near death when he saw her, then he did not commit malpractice and was not lazy.
The lady came to the doctor for an abscess with likely mild surrounding cellulitis (we see this every day in the ER). The standard of care is incision and drainage or warm compresses if the doctor feels like it will burst on its own +/- antibiotics. Now, unless the lady was septic and near death when he saw her, then he did not commit malpractice and was not lazy.
Posted on 5/11/18 at 2:04 pm to slackster
Yup...she probably OD'd on the pain meds she was given.
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