Topic Overview
What is necrotizing fasciitis?
Necrotizing
fasciitis is an infection caused by bacteria. It can destroy skin, fat, and the
tissue covering the muscles within a very short time.
The disease sometimes is called
flesh-eating bacteria. When it occurs on the genitals, it is called Fournier
gangrene.
Necrotizing fasciitis is very rare but serious. About 1
out of 4 people who get this infection die from it.footnote 1
Many people who get necrotizing fasciitis are in good health before they get
the infection.
Your risk of getting
this infection is higher if you:
- Have a weak
immune system.
- Have chronic health
problems such as
diabetes, cancer, or liver or kidney
disease.
- Have cuts in your skin, including surgical wounds.
- Recently had
chickenpox or other viral infections that cause a
rash.
- Use steroid medicines, which can lower the body's resistance
to infection.
What causes necrotizing fasciitis?
Necrotizing
fasciitis is caused by several kinds of bacteria. Some of these bacteria also
cause infections such as
strep throat and
impetigo. Usually the infections caused by these
bacteria are mild. But in rare cases they can cause a more dangerous
infection.
You can get necrotizing fasciitis when bacteria enter a wound, such as from an insect bite, a burn, or a cut. You can also get it in:
- Wounds that come in contact with ocean water,
raw saltwater fish, or raw oysters, including injuries from
handling sea animals such as crabs.
- An intestinal surgery site, or in tumors
or gunshot injuries in the intestines.
- A muscle strain or bruise,
even if there is no break in the skin.
The bacteria that cause necrotizing fasciitis can be passed
from person to person through close contact, such as touching
the wound of the infected person. But this rarely happens unless the person who is exposed to the
bacteria has an open
wound, chickenpox, or an
impaired immune system.
What are the symptoms?
The symptoms often start
suddenly after an injury. You may need medical care right away if you have pain that gets better over 24
to 36 hours and then suddenly gets worse. The pain may be much worse than you
would expect from the size of the wound or injury. You may also have:
- Skin that is
red, swollen, and hot to the touch.
- A fever and
chills.
- Nausea and vomiting.
- Diarrhea.
The infection may spread rapidly. It quickly can become
life-threatening. You may go into
shock and have damage to skin, fat, and the tissue covering the muscles. (This damage is called gangrene.) Necrotizing fasciitis
can lead to organ failure and death.
How is necrotizing fasciitis diagnosed?
The doctor
will diagnose your infection based on how suddenly your symptoms started and
how quickly the infection is spreading. The infected tissue may be tested for
bacteria. You also may need
X-rays, a
CT scan, or an
MRI to look for injury to your organs or to find out
how much the infection has spread.
How is it treated?
Early treatment of necrotizing fasciitis is critical. The sooner treatment
begins, the more likely you will recover from the infection and avoid
serious complications, such as limb amputation or death. You may be treated in the intensive care unit (ICU) at the hospital.
Treatment
may include:
- Surgery that removes infected tissue and fluids
to stop the spread of infection. Surgery is almost always needed. Most people need several surgeries to control the infection. Removing limbs (amputation) or organs may be done to save the person's life, depending on how severe the infection is and where it has spread.
- Medicines (such as antibiotics). These kill the bacteria
causing the infection.
- Procedures to treat complications such as
shock, breathing problems, and organ failure.
- Hyperbaric oxygen therapy.
What if you have been near someone who has the disease?
Necrotizing fasciitis is very rare. Bacteria that cause the disease
usually don't cause infection unless they enter the body through a cut or
other break in the skin.
If you have been in close contact with
someone who has necrotizing fasciitis, your doctor may give you an
antibiotic to help reduce your chances of getting the
infection. If you notice any symptoms of infection (such as pain, swelling, redness, or fever) after you've been in close contact with someone who has necrotizing fasciitis, see your doctor right away.
To help prevent any kind of infection, wash your hands
often. And always keep cuts, scrapes, burns, sores, and bites clean.