Necrotizing Fasciitis (Flesh-Eating Bacteria)

Necrotizing fasciitis (NF) is a rapidly progressive infection that primarily affects the subcutaneous connective tissue planes (fascia), where it may quickly spread to involve adjacent soft tissue, leading to widespread necrosis (tissue death).

Several different types of flesh-eating bacteria may cause this life-threatening condition, which can affect both healthy individuals as well as those with underlying medical problems. Though rarely encountered, there has been an increase in the incidence of necrotizing fasciitis over the last few decades. It is estimated that there are between 500-1,000 cases of necrotizing fasciitis in the United States each year. Early identification and prompt treatment of necrotizing fasciitis is critical to manage the potentially devastating consequences of this medical emergency.

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.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.

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 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.

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. This can help prevent tissue death and promote healing.

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