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What is Necrotizing Fasciitis?




Though the condition is considered rare, with 0.40 cases per 100,000 people reported yearly, necrotizing fasciitis, otherwise known as flesh-eating bacteria, is a life-threatening disease.


With around 1,000 to 1,800 deaths occurring annually in the United States alone, this dreaded disease requires immediate medical attention.


What is necrotizing fasciitis and what kind of treatments are available for this often fatal condition?


What is Necrotizing Fasciitis?

Necrotizing fasciitis is a rare bacterial infection that spreads rapidly throughout the body and sometimes causes immediate death.


Patients suffering from this disease may present the following symptoms:


  • Tenderness to palpation to the local area and peri-wound

  • Erythema, purpura, and swelling

  • Intense pain

  • Flu-like symptoms

  • History of some form of trauma

  • Sepsis symptoms such as fever, altered mental state, and diabetic ketoacidosis which is usually accompanied by trauma to the skin

  • Bleeding, gangrene, and necrosis which can lead to septic shock, systemic inflammatory response syndrome (SIRS), or in some cases, even death.


It should be noted that awareness of the presentation of necrotizing fasciitis is extremely critical not just because of the disease’s rapid progression but also because there’s a high probability of misdiagnosis due to the vague symptoms the condition may present such as erythema, fever, or pain.


Types of Necrotizing Fasciitis

Necrotizing Fasciitis can be classified into 2 types.


Type 1 is the kind of necrotizing fasciitis caused by both aerobic and anaerobic bacteria while Type 2 is usually caused by Group A beta haemolytic Streptococcus and Staphylococcus aureus.



How does it come about?

Flesh-eating bacteria may occur as a complication of several surgical procedures as well as medical conditions which may include the following:


  • Cardiac catheterization

  • Vein sclerotherapy

  • Diagnostic laparoscopy


Patients suffering from the following conditions may also be at a higher risk of contracting necrotizing fasciitis:


  • Chronic disease

  • Diabetes

  • Immunosuppression

  • Intravenous drug use

  • Peripheral vascular disease

  • Renal failure


The bacteria that cause necrotizing fasciitis may enter the body through breaks in the skin which may include the following:


  • Burns

  • Cuts

  • Insect bites

  • Puncture wounds

  • Surgical wounds


It’s also worth noting that one can also get necrotizing fasciitis from blunt trauma or injuries that do not break the skin.


Diagnosis

Diagnosis for necrotizing fasciitis can be difficult considering how many infections look similar to it, especially when it’s in the earlier stages. Given the urgency, doctors may diagnose this disease through the following methods:


Biopsy (Taking a tissue sample)

Bloodwork (to detect possible infection and muscle damage)

Imaging such as CT scan, MRI, or ultrasound


The key is to begin treatment immediately since flesh-eating bacteria spreads fast. In some cases, doctors may not even wait for the test results if they believe the patient is suffering from the dreaded disease.


As quickly as the disease spreads, however, it is considered rarely contagious which means it can’t be passed on or spread to another person through close contact.


Treatment

Necrotizing Fasciitis is a surgical emergency which means the patient should be admitted immediately to a surgical ICU (intensive care unit). Surgical debridement is required until tissue necrosis is stopped and the growth of fresh tissue is observed. Amputation may also be necessary in some cases.


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