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Necrotizing Fasciitis: A Deadly Flesh-Eating Disease

Necrotizing Fasciitis 101

Necrotizing fasciitis is a rare but potentially fatal bacterial skin infection that quickly spreads to deeper tissues and can cause their death. Severe pain, skin discoloration, blisters, fever, and vomiting are signs to watch out for. This condition is a medical emergency that is treated with antibiotics and may require surgery.

A “flesh-eating infection” sounds like the stuff of nightmares. But necrotizing fasciitis is real enough. The bacteria which cause this infection don’t really “eat” flesh but, rather, release toxins which damage tissues. The results, however, are often life-threatening or deadly.1 Here’s a closer look at this condition.

Necrotizing Fasciitis Is A Serious Infection Of Skin And Deep Tissue

Necrotizing fasciitis is a rare but dangerous infection that affects your skin, spreads rapidly, and kills your body’s soft tissue. In fact, the word “necrotizing” means “that which causes the death of tissues.” In people with this condition, bacteria can infect tissue beneath the skin, as well as fascia, which is connective tissue that surrounds your nerves, muscles, blood vessels, and fat. The toxins produced by these bacteria can also cause infected tissue to die. Sepsis, organ failure, and even death are outcomes if the infection isn’t treated in time.

Infection-Causing Bacteria Mostly Enter Through A Cut Or Wound

Necrotizing fasciitis symptoms can develop from within a few hours to a few days of injury and infection. The challenge is that it is often confused with other less serious conditions like flu, gastrointestinal problems, or cellulitis.

A range of bacteria including group A Streptococcus (group A strep), Clostridium, Klebsiella, Staphylococcus aureus, Escherichia coli, and Aeromonas hydrophila can cause necrotizing fasciitis. Depending on the type of bacteria involved, necrotizing fasciitis is divided into type I, II, III, and IV. Group A strep bacteria are, however, the most common culprits. These bacteria usually live on the skin, throat, or gut of people without causing major problems. But in rare cases, they may cause necrotizing fasciitis by getting into deep tissue. An infection can happen when:

  • Bacteria enter the body through punctured or broken skin caused by pokes (say, from a thorn or needle), insect bites, scratches, cuts, or other wounds. This is the most common way of getting necrotizing fasciitis.2
  • In some instances, a break in the skin cannot be found in people with this condition. Bacteria present elsewhere in the body may enter the bloodstream and cause an infection. 3
  • While this condition usually develops via bacteria already present in your body or on your skin, in rare cases, it may also spread from a person who has necrotizing fasciitis.4

Symptoms Include Intense Pain, Skin Discoloration, Blisters, Fever, And Vomiting

A hallmark sign to watch out for is severe pain that is disproportionate to the size or extent of a wound or cut. This may even set in 24–48 hours before other skin symptoms like redness or swelling appear.5

People with this condition often start to experience symptoms within hours of an injury. Symptoms can include:

  • Intense pain: You may notice a scratch or cut on your skin hurts, but, here, the pain is likely to be more intense than the size of the injury would warrant. This is because it is linked to the deep tissue damage occurring within your body rather than the superficially visible scrape or cut. But as the infection worsens and nerves and tissues get destroyed, the pain may improve.
  • Swelling, skin discoloration, and blisters: You may notice that the affected area is warm to the touch. There will also be purplish or reddish discoloration and swelling that rapidly spreads. The swollen area will typically feel firm. You may also notice dark blotches and spots on the skin which rapidly turn into fluid-filled lesions or blisters.
  • Fever and flu-like symptoms: Initially, you may experience flu-like symptoms such as fever, nausea, stomach ache, diarrhea, chills, general body aches, and sore throat.
  • Confusion, dizziness, fatigue: If necrotizing fasciitis is not treated, the infection can quickly spread and may affect vital organs. This can cause symptoms such as dizziness and fatigue. A person may also become delirious or confused at this stage.6 7 8

Poor Immunity Can Increase Your Risk

Anybody, including healthy and young people, can get necrotizing fasciitis.9 In fact, around half the cases of necrotizing fasciitis cases caused by streptococcal bacteria are seen in otherwise healthy and young people.10 But health problems that hamper your immunity may increase your risk. Some conditions that can up your risk of necrotizing fasciitis include:

  • Kidney disease
  • Diabetes
  • Cancer
  • Chronic diseases that make your immune system weak11

NF Requires Emergency Medical Treatment: Do Not Delay!

Necrotizing fasciitis is a medical emergency as it can spread rapidly and cause serious issues such as organ failure and blood poisoning. The fatality risk is high, with death in 1–2 out of every 5 cases.12 Which is why you need to seek immediate treatment if you experience symptoms which suggest the condition.

Treatment Involves Antibiotics, Surgery, And Supportive Measures

There’s no clear-cut way yet to prevent necrotizing fasciitis though vaccinations against some strains of bacteria are being studied. Proper first-aid and care of any wounds, even minor, non-infected ones, is your best defense.

People with necrotizing fasciitis typically need to be hospitalized for a while. Treatment includes:

  • Antibiotics: Strong antibiotics are generally administered intravenously to counter the infection.
  • Surgery: The bacteria involved in necrotizing fasciitis is often anaerobic, that is, thriving when there is no oxygen. So exposure to air via surgery may help kill them. Also, antibiotics might not be able to get to all infected parts if soft tissue has been destroyed and blood flow reduced by toxins. So, surgery is also often required to remove dead tissue.
  • Rehabilitation and physical therapy: In some cases, affected limbs may need to be amputated. People may then need rehabilitation support in order to adapt to the disability.
  • Supportive treatment: Might include measures to control your fluid levels, organ functions, and blood pressure. 13 14

References   [ + ]

1, 4, 9, 12, 14. Necrotising fasciitis. National Health Service.
2, 13. Necrotizing Fasciitis. Centers for Disease Control and Prevention.
3. Necrotising fasciitis. DermNet NZ.
5. Davoudian, Pejman, and Neil J. Flint. “Necrotizing fasciitis.” Continuing Education in Anaesthesia Critical Care & Pain 12, no. 5 (2012): 245-250.
6, 11. Necrotizing Fasciitis. Centers for Disease Control and Prevention.
7, 10. Necrotizing fasciitis. National Institutes of Health.
8. What Are Flesh-Eating Bacteria, and How Do You Fight Them?. National Geographic.

Disclaimer: The content is purely informative and educational in nature and should not be construed as medical advice. Please use the content only in consultation with an appropriate certified medical or healthcare professional.