The patient is a 51-year-old female with a past medical history of uncontrolled diabetes mellitus type II (as evidenced by A1C), hypertension, and morbid obesity to 385 pounds. The patient presented to the ED with right groin pain, fever, chills, altered mental status, and severe hyperglycemia to 648. Upon examination, patient was found to have -- and imaging confirmed -- a necrotizing soft tissue infection of the perineum extending to the groin involving the genitalia and lower abdomen, and was in septic shock. The patient was admitted for emergent surgical debridement. Approximately 1400 square centimeters of necrotic right groin tissue tracking inferior to the right labia majora and abdominal wall was excised. On day two post admission,