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Acting Fast Is Key with Necrotizing Fasciitis

Doctor bandaging girl's arm

Necrotizing fasciitis (NECK-re-tie-zing FASH-e-i-tis) is a rare bacterial infection that spreads quickly in the body and can cause death. See a doctor right away if you have a fever, dizziness, or nausea soon after an injury or surgery.

Necrotizing fasciitis is a bacterial infection of the tissue under the skin that surrounds muscles, nerves, fat, and blood vessels. The bacteria most commonly get into the body through a break in the skin. Once in the body, the bacteria spread quickly and destroy the tissue they infect. Media reports often call them “flesh eating bacteria.” Unfortunately, necrotizing fasciitis can result in a loss of limbs and even death. Accurate diagnosis, rapid antibiotic treatment, and prompt surgery are important to stopping this infection.

Symptoms Can Often Be Confusing and Develop Quickly

Early symptoms of necrotizing fasciitis include:

  • A red or swollen area of skin that spreads quickly
  • Severe pain, including pain beyond the area of the skin that is red or swollen
  • Fever

See a doctor right away if you have these symptoms after an injury, even if the injury doesn’t break the skin. Even though minor illnesses can cause symptoms like these, people should not delay getting medical care.

Later symptoms of necrotizing fasciitis can include:

  • Ulcers, blisters, or black spots on the skin
  • Changes in the color of the skin
  • Pus or oozing from the infected area
  • Dizziness
  • Fatigue (tiredness)
  • Diarrhea or nausea
Man's hand with intravenous tube

Doctors treat necrotizing fasciitis with IV antibiotics.

People with Necrotizing Fasciitis Need Prompt Treatment

Antibiotics and surgery are typically the first lines of defense if a doctor suspects someone has necrotizing fasciitis.

Doctors often need to perform surgery in order to

  • Diagnose the illness
  • See how deep the infection has spread
  • Quickly remove diseased tissue

Since necrotizing fasciitis can spread so rapidly, patients often must get surgery done very quickly. Doctors also give strong antibiotics through a needle into a vein (IV antibiotics) to try to stop the infection. Sometimes, however, antibiotics cannot reach all of the infected areas because the bacteria have killed too much tissue and reduced blood flow. When this happens, doctors have to surgically remove the dead tissue. Sometimes doctors have to remove the infected limb (e.g., leg, foot, arm) to stop the infection from spreading further. It is not unusual for someone with necrotizing fasciitis to end up needing multiple surgeries.

While Rare, Some People Are More Likely to Get Necrotizing Fasciitis

Necrotizing fasciitis is rare. Your chances of getting it are extremely low if you have a strong immune system and practice good hygiene and proper wound care.

Most people who get necrotizing fasciitis have other health problems that may lower their body’s ability to fight infection. Some of these conditions include:

  • Diabetes
  • Kidney disease
  • Cancer

People Rarely Spread Necrotizing Fasciitis to Other People

In general, someone with necrotizing fasciitis does not spread the infection to others. Most cases of necrotizing fasciitis occur randomly. The most common way of getting necrotizing fasciitis is when the bacteria enter the body through a break in the skin, including

  • Cuts and scrapes
  • Burns
  • Insect bites
  • Puncture wounds (including those due to IV drug use)
  • Surgical wounds

Good Wound Care Is Important

Common sense and good wound care are the best ways to prevent bacterial skin infections.

  • Clean all minor cuts and injuries that break the skin (like blisters and scrapes) with soap and water.
  • Clean and cover draining or open wounds with clean, dry bandages until they heal.
  • See a doctor for puncture and other deep or serious wounds.
  • Wash hands often with soap and water or use an alcohol-based hand rub if washing is not possible.
  • Care for fungal infections like athlete’s foot.

If you have an open wound or skin infection, avoid spending time in

  • Hot tubs
  • Swimming pools
  • Natural bodies of water (e.g., lakes, rivers, oceans)

What’s in a Name?

Necrotizing means causing the death of tissues. Fasciitis means inflammation of the fascia (the tissue under the skin that surrounds muscles, nerves, fat, and blood vessels).

Many Bacteria Can Cause Necrotizing Fasciitis

Many types of bacteria can cause necrotizing fasciitis, including:

  • Group A Streptococcus or group A strep
  • Bacterioides
  • Klebsiella
  • Clostridium
  • Escherichia coli or E. coli
  • Staphylococcus aureus
  • Aeromonas hydrophila

Public health experts believe group A Streptococcus (group A strep) is the most common cause of necrotizing fasciitis. Group A strep are the same bacteria that cause strep throat and other common, but generally mild infections.

CDC Tracks Necrotizing Fasciitis Caused by Group A Strep

CDC tracks necrotizing fasciitis caused by group A strep with a special system called Active Bacterial Core surveillance (ABCs). Since 2010, approximately 700 to 1200 cases occur each year in the United States. This is likely an underestimate. According to ABCs data, the number of annual group A strep necrotizing fasciitis infections reported to ABCs does not appear to be rising.

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