Necrotizing fasciitis

Written by: Ellis Schroeder

Also called ‘the flesh-eating disease,’ necrotizing fasciitis is a rare, rapidly progressive, and dangerous infection of the skin caused by various bacteria. It can result in sepsis, shock, loss of limbs, organ failure, and even death.

While many different bacteria can cause this disease, experts believe that Group A Streptococcus bacteria cause most necrotizing fasciitis cases. This bacteria commonly enters the body through a skin break, often by a cut, burn, wound, or insect bite.

This disease kills over 56 patients annually, with a mortality rate of 24-34%. According to the Centers for Disease Prevention and Control (CDC), “Since 2010, approximately 700 to 1,150 cases occur each year in the United States. This is likely an underestimate.” The disease is most common in the Netherlands, but cases are recorded worldwide.

This infection spreads through the body at a fast rate. Necrotizing fasciitis most commonly occurs on the hands, arms, feet, and legs, but it can also occur in places such as the groin area. Early symptoms can include a red, warm, or swollen patch of skin that expands quickly, fever, and intense pain. Later symptoms can include ulcers, blisters, black spots on the skin, changes in skin color, fatigue, dizziness, nausea, and pus from the infected area. Symptoms of this infection often overlap with other illnesses, leading to difficulties in diagnosing. Biopsies, blood tests, and imaging (CT scans, MRIs, ultrasounds, etc.) can help in diagnoses.

Treatment of necrotizing fasciitis is needed promptly because of the infection's rapid progression. This typically starts with antibiotic treatment through an IV and even surgery. Doctors may have to surgically remove the dead tissue from this infection. The infection can prevent blood flow, so a blood transfusion may be needed.

Prevention of necrotizing fasciitis involves wound care: cleaning all breaks in the skin with soap and water, using clean and dry bandages, washing hands frequently, and visiting one's doctor for serious wound injuries.

Sources:

Image source: BC Open Textbook

Centers for Disease Prevention and Control (CDC). “Necrotizing Fasciitis: Acting Fast Is Key.” CDC, https://www.cdc.gov/groupastrep/diseases-public/necrotizing-fasciitis.html#cause. Accessed 23 July 2022.

Nawijn, Femke, et al. “Incidence and mortality of necrotizing fasciitis in The Netherlands: the impact of group A Streptococcus - BMC Infectious Diseases.” BMC Infectious Diseases, 6 December 2021, https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-021-06928-5. Accessed 23 July 2022.