Necrotizing fasciitis
| Necrotizing fasciitis | |
|---|---|
| Other names | Flesh-eating bacteria, flesh-eating bacteria syndrome, necrotizing soft tissue infection (NSTI), fasciitis necroticans |
| Person with necrotizing fasciitis. The left leg shows extensive redness and tissue death. | |
| Pronunciation |
|
| Specialty | Infectious disease |
| Symptoms | Severe pain, fever, purple colored skin in the affected area |
| Usual onset | Sudden, spreads rapidly |
| Causes | Multiple types of bacteria, occasional fungus |
| Risk factors | Poor immune function such as from diabetes or cancer, obesity, alcoholism, intravenous drug use, peripheral artery disease |
| Diagnostic method | Based on symptoms, medical imaging |
| Differential diagnosis | Cellulitis, pyomyositis, gas gangrene, toxic shock syndrome or toxic shock-like syndrome, pyoderma gangrenosum, deep vein thrombosis, Mucormycosis, brown recluse spider bite |
| Prevention | Wound care, handwashing |
| Treatment | Surgery to remove the infected tissue, intravenous antibiotics |
| Prognosis | ~30% mortality with treatment, ~100% mortality without treatment |
| Frequency | 0.7 per 100,000 per year |
Necrotizing fasciitis (NF), also known as flesh-eating disease, is an infection that kills the body's soft tissue. It is a serious disease that begins and spreads quickly. Symptoms include red or purple or black skin, swelling, severe pain, fever, and vomiting. The most commonly affected areas are the limbs and perineum.
Bacterial infection is by far the most common cause of necrotizing fasciitis. Despite being called a "flesh-eating disease", bacteria do not eat human tissue. Rather, they release toxins that cause tissue death. Typically, the infection enters the body through a break in the skin such as a cut or burn. Risk factors include recent trauma or surgery and a weakened immune system due to diabetes or cancer, obesity, alcoholism, intravenous drug use, and peripheral artery disease. It does not usually spread between people. The disease is classified into four types, depending on the infecting organisms. Medical imaging is often helpful to confirm the diagnosis.
Necrotizing fasciitis is treated with surgery to remove the infected tissue, and antibiotics. It is considered a surgical emergency. Delays in surgery are associated with a much higher risk of death. Despite high-quality treatment, the risk of death remains between 25 and 35%.