Necrotizing Fasciitis

Necrotizing fasciitis ("flesh-eating" bacteria) is an invasive soft tissue bacterial infection of the skin, often developing in patients who have had minor skin trauma (50% to 85%). The disease is also seen in immunocompromised and postoperative patients. If the area of infection involves the perineum, the disease is called Fournier's gangrene.

Causes

• Surgical procedures that may cause local tissue injury and bacterial invasion and resulting in necrotizing fasciitis. These procedures such as includes surgery for intraperitoneal infections and drainage of ischiorectal and perianal abscesses.
• IM injections and IV infusions may also lead to necrotizing fasciitis.
• Several bacteria may cause necrotizing fasciitis (eg. Group A streptococcus, Vibrio vulnificus, Clostridium perfringens, Bacteroides fragilis), of which Group A streptococcus is the most common cause.
• Another type of necrotizing fasciitis may be caused by multiple bacteria found in the intestine. This type of necrotizing fasciitis most often affects people who have diabetes or peripheral arterial disease.

Symptoms

• Patients usually have severe pain in a localized area. This is the earliest and most consistent symptom.

Signs

• May be very minimal initially (i.e., pain is out of proportion to physical findings)
• Erythema and swelling without demarcated margins initially
• Rapidly evolves to include the development of reddish purple patches and then bullae
• Area becomes necrotic, edematous, and possibly crepitant
• Surrounding surface becomes involved as the infection spreads along the subcutaneous tissue and fascia.
• Fever is common as disease progresses.

Treatment

• You can treat NF in the hospital with antibiotic IV therapy and aggressive debridement (removal) of affected tissue.
• Another treatment for Necrotizing Fasciitis is Hyperbaric oxygen therapy, In which, it provides your body with high levels of oxygen and may help control infection and reduce the need for surgery.
• Several diseases such as includes shock, kidney failure, and breathing problems caused by damage to the lungs are the most common complications of necrotizing fasciitis. Many people who develop necrotizing fasciitis will require use of a kidney machine (hemodialysis) to treat kidney failure, and about one-half will need help breathing using a ventilator machine until their condition improves.