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Lahey Health is now part of Beth Israel Lahey Health

by EBSCO Medical Review Board
(Flesh-eating disease; Streptococcal gangrene)

Definition

Necrotizing fasciitis is a rare but serious infection. It can spread quickly and become life-threatening.

Causes

Necrotizing fasciitis is caused by a bacteria. There are different types of bacteria that can cause this infection. It most often enters through a break in the skin like a scrape, cut, or surgical wound. The infection causes damage and death of tissue. Both the infection and tissue damage cause symptoms.

Risk Factors

Risk factors include:

  • Injury to the skin from scrapes, cuts, burns, or insect bites
  • Recent surgery and wounds from medical care
  • Punctures of the skin from IVs or injections

A weaker immune system may also increase the risk of an infection. Health issues or treatment that may increase the risk of infection include:

  • Diabetes
  • Liver damage
  • Kidney disease
  • IV drug use
  • Alcohol abuse
  • Long-term use of medicine that lowers the immune system
  • Poor nutrition

Symptoms

Early symptoms may include:

  • Pain that is more than expected
  • Redness and swelling that spreads quickly
  • Fever
  • Feeling generally achy and tired
  • Nausea or diarrhea

Later symptoms may include:

  • Blisters and wounds on skin
  • Blue-black spots develop on skin
  • Severe swelling
  • Loss of feeling in area
  • Increasing pain
  • Feeling tired and weak

Diagnosis

You will be asked about your symptoms and past health. A physical exam will be done. An infection may be suspected based on the exam. Other tests will need to be done to look for necrotizing fasciitis. They may include:

  • Blood tests—to look for signs of infection
  • Biopsy —a sample of infected tissue will be sent to a lab
  • Surgery—to closely examine infected tissue

Treatment

Necrotizing fasciitis is an emergency. Treatment will begin as soon as possible. A hospital stay will be needed. Treatment steps include:

  • Antibiotics given through IV. This allows high amounts to enter the body quickly.
  • Surgery will be needed to remove dead tissue. This is needed for overall health and to help fight the infection.

Swelling and tissue damage can slow blood flow to some areas. It will take longer for antibiotics to get to the infected site. More surgeries may be needed to clean out dead or damaged tissue.

The infection can spread throughout the body or to major organs. This will cause more severe problems with long-term health issues.

Prevention

Good wound care may decrease the risk of infections. This includes:

  • Clean minor wounds with soap and water.
  • Cover open wounds with a bandage until they scab over.
  • Avoid swimming pools, bodies of water (like lakes), and hot tubs if you have an open wound.
  • See a doctor for large wounds or punctures.
  • Follow care steps for any skin infections.

RESOURCES

American Academy of Dermatology  https://www.aad.org 

Family Doctor—American Academy of Family Physicians  http://www.familydoctor.org 

CANADIAN RESOURCES

Public Health Agency of Canada  http://www.canada.ca 

The College of Family Physicians of Canada  http://www.cfpc.ca 

References

Necrotizing fasciitis. Center for Disease Control (CDC) website. Available at: https://www.cdc.gov/groupastrep/diseases-public/necrotizing-fasciitis.html. Updated October 18, 2018. Accessed October 11, 2019.

Necrotizing fasciitis. EBSCO DynaMed website. Available at:  https://www.dynamed.com/condition/necrotizing-fasciitis  . Updated June 6, 2018. Accessed October 11, 2019.

Necrotizing fasciitis. National Organization of Rare Disease (NORD) website. Available at: https://rarediseases.org/rare-diseases/necrotizing-fasciitis/. Updated 2019. Accessed October 11, 2019.

Revision Information