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Necrotizing Fasciitis (Flesh-Eating Disease)

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Medical Author: Charles Patrick Davis, MD, PhD Medical Editor: Melissa Conrad Stppler, MD

Necrotizing fasciitis (flesh-eating disease) facts What is necrotizing fasciitis? Do different types of necrotizing fasciitis exist? What causes necrotizing fasciitis? What are necrotizing fasciitis symptoms and signs? How is necrotizing fasciitis diagnosed? What is the treatment for necrotizing fasciitis? How is necrotizing fasciitis prevented? Is necrotizing fasciitis contagious? Who is at risk to get necrotizing fasciitis? What is the prognosis (outcome) for patients with necrotizing fasciitis? What are complications of necrotizing fasciitis? What are some additional sources of information on necrotizing fasciitis? Patient Comments: Necrotizing Fasciitis - Cause Patient Comments: Necrotizing Fasciitis - Treatments

What Is a "Flesh-Eating" Bacterial Infection?

Medical Author: Melissa Conrad Stppler, MD Medical Editor: Jay W. Marks, MD, William C. Shiel Jr., MD, FACP, FACR Media reports have popularized the term "flesh-eating bacteria" to refer to a very rare but serious bacterial infection known as necrotizing fasciitis. Necrotizing fasciitis is an infection that starts in the tissues just below the skin and spreads along the flat layers of tissue (known as fascia) that separate different layers of soft tissue, such as muscle

and fat. This dangerous infection is most common in the arms, legs, and abdominal wall and is fatal in 30%-40% of cases. Although necrotizing fasciitis may be caused by an infection with one or more than one bacterium, in most cases the term flesh-eating bacteria has been applied to describe infections caused by the bacterium known asStreptococcus pyogenes. The term flesh-eating has been used because the bacterial infection produces toxins that destroy tissues such as muscles, skin, and fat. Streptococcus pyogenes is a member of the group A streptococci, a group of bacteria that are responsible for mild cases of sore throat(pharyngitis) and skin infections, as well as rare, severe illnesses such as toxic shock syndromeand necrotizing fasciitis. Most infections with group A streptococci result in mild illness and may not even produce symptoms. Learn the symptoms of necrotizing fasciitis

Necrotizing fasciitis (flesh-eating disease) facts

Necrotizing fasciitis refers to a rapidly spreading infection, usually located in fascial planes of connective tissue that results in tissue death (necrosis). Different types of bacterial infection can cause necrotizing fasciitis. The majority of cases begin with an existing infection, most frequently on an extremity or in awound. Necrotizing fasciitis is a serious condition that is often associated with sepsis and widespread organ failure. Treatment of an infection caused by flesh-eating bacteria involves antibiotics and surgical debridement of the wound areas as well as supportive measures such as insertion of a breathing tube, intravenous administration of fluids, and drugs to support the cardiovascular system.

What is necrotizing fasciitis?

Necrotizing fasciitis is a term that describes a disease condition of rapidly spreading infection, usually located in fascial planes of connective tissue that results in tissue necrosis (dead and damaged tissue). Fascial planes are bands of connective tissue that surround muscles, nerves, and blood vessels. Fascial planes can bind structures together as well as allow body structures to slide over each other effectively. The disease occurs infrequently, but it can occur in almost any area of the body. Although many cases have been caused by group A beta-hemolytic streptococci (Streptococcus pyogenes), most investigators now agree that many different bacterial genera and species, either alone or together (polymicrobial), can cause this disease. Occasionally, mycotic (fungal) species cause necrotizing fasciitis. Historically, several people first described this condition in the 1840s to 1870s, and Dr. B. Wilson first termed the condition necrotizing fasciitis in 1952. It is likely that the disease had been occurring for many centuries before it was first described in the 1800s. Currently, there are many names that have been used loosely to mean the same disease as necrotizing fasciitis: flesh-eating bacterial infection or flesh-eating disease; suppurative fasciitis; dermal, Meleney, hospital, or Fournier's gangrene; and necrotizingcellulitis. Body regions frequently have the term necrotizing placed before them to describe the initial localization of necrotizing fasciitis (for example, necrotizing colitis, necrotizing arteriolitis), but they all refer to the same disease process in the tissue.

Important in understanding necrotizing fasciitis is the fact that whatever the infecting organism(s), once it reaches and grows in connective tissue, the spread of the infection can be so fast (investigators suggest some organisms can progress to involve about 3 centimeters of tissue per hour) that the infection becomes difficult to stop even with both antimicrobial drugs and surgery. Mortality (death) rates have been reported as high as 75% for necrotizing fasciitis associated with Fournier's (testicular) gangrene. Patients with necrotizing fasciitis have an ongoing medical emergency that often leads to death or disability if it is not promptly and effectively treated.

Picture of necrotizing fasciitis (flesh-eating disease)

Reviewed by Melissa Conrad Stppler, MD on 5/18/2012

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