Necrotizing fasciitis | |
---|---|
Other names | Flesh-eating bacteria, flesh-eating bacteria syndrome,[1] necrotizing soft tissue infection (NSTI),[2] 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[3] |
Usual onset | Sudden, spreads rapidly[3] |
Causes | Multiple types of bacteria,[4] occasional fungus[5] |
Risk factors | Poor immune function such as from diabetes or cancer, obesity, alcoholism, intravenous drug use, peripheral artery disease[2][3] |
Diagnostic method | Based on symptoms, medical imaging[4] |
Differential diagnosis | Cellulitis, pyomyositis, gas gangrene, toxic shock syndrome or toxic shock-like syndrome, pyoderma gangrenosum, deep vein thrombosis, Mucormycosis, brown recluse spider bite[6] |
Prevention | Wound care, handwashing[3] |
Treatment | Surgery to remove the infected tissue, intravenous antibiotics[2][3] |
Prognosis | ~30% mortality with treatment,[2] ~100% mortality without treatment |
Frequency | 0.7 per 100,000 per year[4] |
Necrotizing fasciitis (NF), also known as flesh-eating disease, is an infection that kills the body's soft tissue.[3] It is a serious disease that begins and spreads quickly.[3] Symptoms include red or purple or black skin, swelling, severe pain, fever, and vomiting.[3] The most commonly affected areas are the limbs and perineum.[2]
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.[3] 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.[3][2] It does not usually spread between people.[3] The disease is classified into four types, depending on the infecting organisms.[4] Medical imaging is often helpful to confirm the diagnosis.[4]
Necrotizing fasciitis is treated with surgery to remove the infected tissue, and antibiotics.[2][3] It is considered a surgical emergency. Delays in surgery are associated with a much higher risk of death.[4] Despite high-quality treatment, the risk of death remains between 25 and 35%.[2]