The clinical presentations of deep soft tissue infections can, initially, mimicry superficial skin infections such as erysipelas. However, a rapidly deteriorating health status, the spreading of the lesions and the lack of clear visual limitation of the infection on the skin are hallmarks of a more severe underlying infection, which may endanger patients' life. An immediate adequate multidisciplinary approach to therapy within a few hours is mandatory. The first step is surgical exploration with debridement of all infected tissues, accompanied by antibiotic therapy and additional supportive measures. Despite progress in the understanding of the physiopathology, the delay between suspicion of diagnosis and surgical exploration remains critical. Because of the low incidence of such severe infections, only multicenter studies might reveal deeper insights of optimal therapeutic strategies in the future and for possible improved patients' survival.