Necrotizing fasciitis is a serious disease that's commonly treated by orthopaedic surgeons. Also known as flesh-eating disease, it's a bacterial infection that spreads quickly and can be deadly.
Flesh-eating bacteria can enter your body through a wound and attack the connective tissue below the skin.
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Doctors define necrotizing fasciitis (flesh-eating disease) as a bacterial infection that starts below the surface of the skin. The bacteria attack the fascia — the connective tissue below the skin surrounding your muscles and organs.
The infection can start any place there's a break in the skin where bacteria can enter. Flesh-eating disease is very serious, which is why doctors start treatment as soon as they suspect it.
Flesh-eating disease is very rare. It affects about 4 in 1 million Americans every year, according to the National Library of Medicine.
Various types of bacteria cause flesh-eating disease. These bacteria may be present in the environment, such as in bodies of water, or carried by humans.
The most common cause of necrotizing fasciitis is Group A Streptococcus (strep) bacteria, which also causes strep throat. While strep throat from Group A strep is common, it's very rare for any type of bacteria to cause necrotizing fasciitis.
Other types of bacteria that can also cause necrotizing fasciitis include:
Often, more than one type of bacteria infects the fascia in flesh-eating disease.
Anyone can get flesh-eating disease — even young, healthy people. But some people are at higher risk.
You may be at a higher risk of getting flesh-eating disease if you:
Because flesh-eating bacteria spread quickly throughout the body, it can have severe complications. These include:
To avoid prevent flesh-eating disease:
Early symptoms of flesh-eating disease include:
Later symptoms of flesh-eating disease include:
Go to the emergency department immediately if you have signs of flesh-eating disease. The main, early symptom is swelling and red or discolored skin that spreads quickly from a wound.
Because this disease only becomes more life-threatening, doctors treat necrotizing fasciitis based on the signs and symptoms, including how the skin looks.
Your doctor will order tests alongside treatment to confirm the diagnosis and guide further treatment.
As your care team treats your wound, they may order:
Doctors treat necrotizing fasciitis with surgery and medicine. Many people require multiple surgeries.
In a procedure called "debridement," the surgeon opens up the skin around the wound. They then remove all dead and infected tissue, along with tissue that may be infected. They thoroughly clean the area.
A debridement requires general anesthesia, meaning you're asleep during the procedure. After surgery, the area is packed with gauze, which health providers will change daily.
Your team will watch the area closely for signs of infection after surgery. They'll do more debridements, as needed. In some cases, surgeons may need to amputate part of a limb to stop the infection from spreading.
Your doctor may take skin and muscle tissue from a more hidden area of your body and attach it to the wound site. This can improve the long-term appearance and function of the affected area. Sometimes the doctor may need to use artificial skin to close the wound.
Your doctor will prescribe IV antibiotics to help ensure the infection doesn't spread to healthy tissues.
Since damage from the bacteria can cut off blood supply, antibiotics don't get to the infected tissue. That is why debridement also is necessary.
Your doctor may prescribe intravenous immune globulin (human antibodies), which can help to fight infection. You may also need other medicines to support your lungs, heart, liver, or other organs.
Hyperbaric oxygen, or pressurized oxygen, can speed wound healing. Very ill patients who are being monitored by machines can't easily access hyperbaric oxygen chambers. For this reason, doctors use hyperbaric oxygen for small wounds or later in the treatment course.
Even with treatment, about 1 in 5 people with flesh-eating disease will die from it, according to the CDC. People who survive flesh-eating disease usually have reduced function in the affected area due to the destroyed muscle tissue, nerves, and blood vessels.
The earlier in the course of disease people seek treatment, the better their chance of survival.
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