Fulminant fatal necrotising fasciitis in an extremely preterm infant

A 23+0 week gestation twin girl weighing 465 g was born via spontaneous vaginal delivery. On postnatal day 4, a small area of broken skin was noted on her back. Flucloxacillin and gentamicin were commenced and Cavilon cream was applied. Vancomycin was substituted after blood culture grew Staphylococcus epidermidis . A skin swab isolated skin flora only. By postnatal day 10, the lesion had worsened with a haemorrhagic petechial appearance...