**
1. As cause of death came out to be NF [necrotising fascitis], which has symptoms similar to
meningitis like [fever,vomiting,
unconsciousness (altered sensorium)] thus probably was the cause of mis diagnosis.
2. history of cut,scratch or surgery on the skin can result in entry of bacteria inside the body which causes death of the tissues/fascia underneath the skin.
3.as death certificate reads [group A hemolytic streptococcus], which is the most important and more severe cause of NF and are spread through close person-to-person contact, through secretions from the mouth and throat, or from direct skin contact with individuals carrying the organism.
4. people with weakened immune system are more susceptible to NF infection [unhygenic living conditions, intravenous
drug abuse,diabetics,alcoholics,chronic heart and lung disease], if he was suffering from any one of these, thus probably can be an associated factor.
5. cause of death probably was due to:
toxic shock syndrome [septicemia], from the toxins released by the bacteria thereby causing severe fall in blood pressure and death.
PS
. These bacteria make toxins that destroy body tissue directly, as well as causing the body's immune system to destroy its own tissue while fighting the bacteria.
. A recent
chickenpox infection can greatly increase the risk of getting necrotizing
fasciitis.
. chest wall abscess again shows necrotizing
soft tissue infections of the chest wall.