Danger level: High
What is it?
Necrotizing fasciitis is a type of infection that rapidly destroys skin and the tissue beneath it and can lead to death.
Who gets it?
It’s quite rare – Since 1883 there have only been 500 known cases in the United States. It’s about 2-3 times as common in men than women.
It can happen to anyone, but might be more common if you have any of these:
- A problem with your immune system
- A chronic disease, such as diabetes, cancer or liver or kidney disease.
- If you have cuts – such as wounds from operations.
- If you’ve had chickenpox lately, or other viral infections with a rash.
- You take steroids (not the ones used for growing, the ones used to treat a disease).
What causes it?
Necrotizing fasciitis is usually caused by a germ called group A streptococci, (frequently called the “flesh eating bacteria” in relation to this) and sometimes by others.
That bacteria can cause “regular” skin infections. Sometimes, though, a simple damage to the skin (such as a bruise or muscle strain) can cause the germ to enter the area. It then releases poisons (called toxins) that damage the soft tissue below the skin, and then spread rapidly to destroy muscle coverings. Along the way it causes death of the tissue.
The germ can also spread through the blood to the lungs and other organs, which leads to failure of these organs and death.
The progression of all of these can happen in a matter of hours!
Streptococcus – the germ wreaking all the havoc here. If you want to see how necrotizing fasciitis looks like, click here Warning: This photograph contains graphic details that may be difficult to watch. Proceed at your own risk. (necrotizing fasciitis photo by Piotr Smuszkiewicz, Iwona Trojanowska and Hanna Tomczak).
How does it feel?
There will be great pain in the area involved – What’s common here is that the pain doesn’t fit what is seen on the outside – the skin might look fine, but the pain will be very severe. Fever might be present, as well as nausea and vomiting. Within hours, the area will be swollen and tender to touch. Then it will become red, usually with blisters. Later the skin becomes blue, brown or black.
Since the germ spreads through the blood, within hours infected people will enter shock and finally death, if not treated.
How is it discovered?
The rate that the infection spreads will be a clue to the doctor to the fact that this is necrotizing fasciitis. Sometimes, a sample form the skin will be taken to identify the germ. Sometimes an x-ray picture of a CT or MRI scan will be taken.
How is it treated?
Treatment is done by surgery. In the surgery, the doctor will take out the dead tissue, to keep the infection from spreading. Along with that, antibiotics are given against the germ.
Another thing that can be done is hyperbaric oxygen treatment – This means putting the patient in a special container which contains high levels of oxygen. Why does this help?
- Sometimes the germs causing this can’t live with oxygen, and this will simply kill them.
- The infection lowers the level of oxygen in the infected tissue, and white blood cells (the cells responsible for fighting infections) can’t fight the infection properly. By increasing the oxygen level in the tissues, these cells can fight better.
What happens after treatment?
About 30% of people will die because of this infection (much more if it’s not treated on time).
The bottom line: How do I avoid it?
Here are a few things you can do to avoid getting this rare, yet horrible, disease:
- Wash your hands often – This will help prevent not just this, but other infections as well.
- Keep cuts, scrapes, burns, sores, bites or surgical wounds clean.
- Watch for signs of infection: Pain, swelling, pus, heat or redness near a wound or fever without an obvious cause. If any of these appear, seek medical attention immediately. Do not take any anti-inflammatory drugs such as ibuprofen, since they might reduce the symptoms and delay discovery of the infection on time.
- If you recently strained a muscle or sprained a joint and you develop fever, chills and sever pain, seek medical care immediately.
- In rare cases, the germ can spread from one person to another through close contact such as kissing. If you have been in close contact with someone who develops necrotizing fasciitis, your doctor might recommend that you take an antibiotic.
Here’s a story of a survivor. Do you have a story of your own to share? You can do it in the comments.