What Is Necrotizing Fasciitis?
Necrotizing fasciitis, commonly known as flesh-eating disease, is an infection that results in the death of the body’s soft tissue. It is a severe disease of sudden onset that spreads rapidly. Necrotizing fasciitis has been described at least since the time of Hippocrates. The term “necrotising fasciitis” first came into use in 1952. The bacteria that cause necrotizing fasciitis don’t actually “eat” flesh.
Instead, they release toxins that liquefy tissue. This results in widespread, rapid tissue death that can seem like flesh is being eaten by the bacteria that cause the necrotizing fasciitis infection. Once infected, the bacteria can destroy skin, fat, and internal tissues rapidly, sometimes spreading as quickly as an inch every hour. This can lead to sepsis, organ failure, and even death in as many as a third of the people who become infected.
Fortunately, there are only about 1,000 cases of necrotizing fasciitis reported every year. The Centers of Disease Control and Prevention believe this estimate of cases might be on the low side, however.
Several different types of bacteria can cause necrotizing fasciitis. In fact, one of the most common is group A Streptococcus, which is plentiful, can often be found in our bodies, and occasionally causes the illnesses known as strep throat and scarlet fever. Scientists have found that the strains of group A Streptococcusbacteria that can cause necrotizing fasciitis are “supercharged” strains that have also been infected by two different viruses that make them more likely to cause disease.
These dangerous bacteria usually get in through punctured skin, such as cuts or insect bites. The first symptom of a serious infection is often significant pain that results from the deep tissue damage occurring below the skin.
Treatment usually takes two forms: First medicine in the form of antibiotics to attack the infection; and second surgery to expose the affected areas to oxygen. The bacteria at issue are anaerobic, which means exposing them to oxygen can help to kill them. Surgery allows doctors to remove dead and damaged tissues while exposing other areas to oxygen to fight the bacteria.
Necrotizing fasciitis may be prevented with proper wound care and hand washing. It is usually treated with surgery to remove the infected tissue and intravenous antibiotics. Often combinations of antibiotics are used such as penicillin G, clindamycin, vancomycin, and gentamicin. Delays in surgery are associated with a higher risk of death. Despite high quality treatment, the risk of death is between 25% and 35%.
Necrotizing fasciitis affects 0.4 to 1 person per 100,000 per year. Both sexes are affected equally. It becomes more common among older people and is very rare in children.