Rapidly progressive necrotising fasciitis following a stonefish sting: a report of two cases

WM Tang, KK Fung, VC Cheng, L Lucke
Department of Orthopaedics and Traumatology, Queen Mary Hospital, University of Hong Kong, Hong Kong

Two patients developed rapidly progressive necrotising fasciitis after being stung by a stonefish. Both were given a hot-water bath for pain relief. The hot water may have accelerated bacterial growth and the consequent development of necrotising fasciitis. Vibrio vulnificus was cultured from one patient. It is recommended that patients should receive high dose of oral and intravenous antibiotic prophylaxis for vibrio prevention. Antibiotics should be given before or during, not after, a hot-water bath, and the patient's condition should be monitored closely.