About necrotizing fasciitis (flesh-eating disease)

What is necrotizing fasciitis (flesh-eating disease)?

Flesh-eating bacteria (necrotizing fasciitis) is a rare infection of the skin and tissues below it. It can be deadly if not treated quickly.

Necrotizing fasciitis spreads quickly and aggressively in an infected person. It causes tissue death at the infection site and beyond.

Every year, between 600 and 700 cases are diagnosed in the U.S. About 25% to 30% of those cases result in death. It rarely happens in children..

What are the symptoms for necrotizing fasciitis (flesh-eating disease)?

The early symptoms of an infection with flesh-eating bacteria usually appear within the first 24 hours of infection. Symptoms are similar to other conditions like the flu or a less serious skin infection. The early symptoms are also similar to common post-surgical complaints, such as:

  • Serious pain
  • Inflammation
  • Fever
  • Nausea

Symptoms often include a combination of the following:

  • Increasing Pain in the general area of a minor cut, abrasion, or other skin opening.
  • Pain that is worse than would be expected from the appearance of the cut or abrasion.
  • Redness and Warmth around the wound, though symptoms can begin at other areas of the body.
  • Flu-like symptoms such as diarrhea, nausea, fever, dizziness, weakness, and general malaise.
  • Intense thirst due to dehydration.

What are the causes for necrotizing fasciitis (flesh-eating disease)?

Necrotizing fasciitis is commonly caused by group A streptococcus (GAS) bacteria. That's the same type of bacteria that causes strep throat. But, several types of bacteria, such as staphylococcus and others, have also been linked to the disease.

Necrotizing fasciitis happens when these types of bacteria infect the superficial fascia, a layer of connective tissue below the skin.

What are the treatments for necrotizing fasciitis (flesh-eating disease)?

Patients infected with flesh-eating bacteria will undergo several types of treatment. The extent of treatment depends on the stage of the disease when treatment is started. The treatment includes:

  • Intravenous antibiotic therapy.
  • Surgery to remove damaged or dead tissue in order to stop the spread of infection.
  • Medications to raise blood pressure.
  • Amputations of affected limbs, in some cases.
  • Hyperbaric oxygen therapy may be recommended to preserve healthy tissue.
  • Cardiac monitoring and breathing aids.
  • Blood transfusions.
  • Intravenous immunoglobulin. This supports the body's ability to fight infection.

What are the risk factors for necrotizing fasciitis (flesh-eating disease)?

Flesh-eating bacteria transmission

The bacteria that cause necrotizing fasciitis can enter the body through:

  • Surgical wounds
  • Puncture wounds or other injury
  • Burns
  • Minor cuts
  • Insect bites
  • Abrasions

Is there a cure/medications for necrotizing fasciitis (flesh-eating disease)?

Necrotizing fasciitis (flesh-eating disease) progresses rapidly and can result in death hence an early diagnosis and providing appropriate treatment is of utmost importance.

  • Early medical treatment is often presumptive; antibiotics should be started as soon as this condition is suspected.
  • Surgical debridement is the standard treatment for necrotizing fasciitis.
  • Aggressive Necrotizing fasciitis should be performed early, usually as soon as the diagnosis is made.
  • Empiric antibiotics are usually initiated as soon as the diagnosis of NSTI has been made. Culture-guided antibiotic therapy is later made.
  • Moxifloxacin (a fluoroquinolone) and amoxicillin-clavulanate (penicillin) and evaluated the appropriate duration of treatment (varying from 7 to 21 days); however, no definitive conclusions on the efficacy of treatment, could be made.
  • Supportive therapy, often including intravenous hydration, wound care, anticoagulants to prevent thromboembolic events, pain control, etc., are needed.


Symptoms
Severe pain,Purple colored skin in the affected area,Pain in the affected area,Intense pain out of proportion to the signs of the local skin infection,Erythema,Tenderness,Heat,Fever and other flu-like symptoms,Swelling of the painful area,Diarrhea,Vomiting
Conditions
Swelling and intense pain,Ischaemia with blisters and bullae,Hypoxia,Edema and ecchymoses,Fever
Drugs
Use of broad-spectrum antibiotics: Ampicillin or ampicillin–sulbactam combined with metronidazole or clindamycin, Metronidazole, carbapenems, doxycycline and minocycline,Surgical management to limit the spread of infection: surgical debridement, necrosectomy, and fasciotomy are the main features of surgical treatment.

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