Necrotizing Fasciitis


Necrotizing Fasciitis (NF) is commonly known as Flesh-Eating Bacteria.

This name is a misnomer. The bacteria does not actually eat flesh. It releases a toxin that destroys flesh. There is more than one species of bacteria that cause necrotizing fasciitis: Vibrio vulnificus, Clostridium perfringens, Bacteroides fragilis, and Streptococcus pyogenes, which is the most common. These bacteria become harmful when they enter the body, but cause no damage when they settle on epidermal tissue or esophageal. However, when the skin breaks and the bacteria enter the body through the wound, infection occurs. Infection can also occur if the bacteria is ingested. Strep Throat one of the most common infections caused by Streptococcus pyogenes.

The bacteria release a toxin that decimates flesh.  The toxin is the virulence factor: the stronger the toxin, the more damage it causes. Therefore, if transmission were reduced among the more virulent strains, the less virulent strains would be left and cause less damage.

The majority of these bacteria enter the body via a site of trauma. The effects of the infection are almost instantaneous unless the bacteria have become deeply embedded in the tissue. The bacteria can also be taken into the body orally. There is a high mortality rate for those infected with necrotizing fasciitis, and the rate is even higher for those who do not receive immediate medical attention, and even those who do receive medical attention do not have a hundred percent chance of survival. Even among those who do survive the infection, severe disfigurement can occur. Therefore, it is important that medical attention should be sought out immediately after infection.

Everyone is at risk for NF, some more than others. The statistics on prevalence vary from source to source. However, the CDC reports that there were approximately 9,400 cases of invasive Group A Streptococcus reported in 1999, and there are over a million cases of strep throat and impetigo reported yearly.

NF is found world-wide; however, tropical temperatures provide a better growing environment for the bacteria.


What are the symptoms of NF?

It is very important to be able to identify the symptoms of NF. It could save your life. There is a very short incubation period for the bacteria, and symptoms usually occur within a day. Unfortunately, the first symptoms that are experienced are flu-like. This often leads to misdiagnosis. The other symptoms are as follows:
  • Recent trauma somewhere on the body. Sometimes it is very slight, just a scratch. This provides the bacteria access to the host's body.

  • The sight of trauma provides more pain than it should. For example, a paper cut feels like an arm is about to fall off well after the pain should have subsided.

  • Flu-like symptoms such as diarrhea, vomiting, weakness, fever, dehydration, and malaise

  • Swollen tissue around the site of trauma that is hot and painful to the touch

  • Drop in blood pressure and quickening of heart beat

  • The development of a rash over the entire body (not always present)

  • Toxic shock shuts down major organs

Even if no symptoms of NF are present, it is still possible to carry the bacteria. 

It is therefore important to keep practicing good hygiene. The bacteria reside on epidermal tissue as well as within mucus. Someone carrying Streptococcal bacteria can transmit the bacteria to another person through direct skin to skin contact or through mucus to skin contact through a sneeze or cough.  If the new host touches an open wound on his body, the bacteria take up residence. 

If a person infected with Streptococcal bacteria washes his hands often, the bacteria are washed away. If a person washing out all cuts with soap or disinfectant, infection can be avoided.

A person infected with NF, however, is unlikely to transmit the disease to another host through an inanimate object.

Fast treatment of NF saves lives. 

Once NF has been diagnosed, intense hospital treatment is given. Broad spectrum antibiotics are administered intravenously to prevent the host from developing sepsis. Surgery is usually required to remove the infected and dead tissue from the host. Due to the anaerobic nature of the bacteria, the patient may be placed in a hyperbaric oxygen chamber.

Survival is dependant on fast treatment, which is dependant on a quick diagnosis. The mortality rate can reach 25%. Cases of NF with sepsis and renal failure have a mortality rate as high as 70%.

Necrotizing Fasciitis