XXXX , the deadly impersonator.

@entity1 @entity5442 @entity1910 @entity101 @entity39 @entity341 @entity4195 @entity177 @entity1576 @entity158 @entity9156 @entity309
We report two cases of @entity1 with necrotising @entity5442 who presented initially with @entity158 and swelling on a background of respiratory complaints. @entity1 1, a previously well 38-year-old female, underwent various investigations in the @entity341 department for excessive @entity158 and a @entity1910 . @entity1 2, a 61-year-old female with a background of @entity309 and @entity101 , presented to accident and @entity341 feeling generally unwell and was treated for presumed @entity1576 . Both deteriorated rapidly and were referred to the plastic surgery team with soft tissue @entity39 , @entity177 and toxaemia. Large areas of necrotic muscle and skin were debrided, which grew group A streptococci, @entity4195 . @entity1 1 had a high above knee amputation of the left leg with extensive debridement of the right. Despite aggressive surgical intervention and microbiological input with intensive care support, @entity1 2 died. These two cases highlight the importance of early diagnosis and prompt surgical and pharmacological intervention in managing this life-threatening disease. @entity158 is the primary symptom with skin changes being a late and subtle sign in a septic @entity1 . The Laboratory Risk Indicator for @entity9156 (LRINEC) may be of use if there is concern to aid diagnosis of this life-threatening disease.
