KEY POINTS

• Necrotizing fasciitis may be misdiagnosed as cellulitis due to the benign appearance of cutaneous findings early in the clinical course.
• Clues to the diagnosis of necrotizing fasciitis are vital sign abnormalities, swelling, and severe pain out of proportion to cutaneous findings.
• If you are suspicious for necrotizing fasciitis, have a low threshold to start broad-spectrum antibiotics and consult Surgery without delaying for advanced imaging, even if clinical score and plain films are unremarkable.