NECROTIZING FASCIITIS
Necrotizing fasciitis sounds like a dreadful disease, and in fact, it is. It is more commonly known as “Flesh-Eating Disease”. So, what is it exactly?
Necrotizing fasciitis is a rare disease that is very serious and can lead to death in as little as 12-24 hours. Mortality rates are as high as 30%. It is caused by a number of different bacteria but the most common bacteria involved are group A streptococcus (GAS). It is the same bacteria that causes strept throat, and can also cause impeptigo, scarlet fever and rheumatic fever. In more rare instances GAS will cause more serious illnesses including pneumonia, meningitis, bactremia, streptococcal toxic-shock syndrome and flesh-eating disease.
In necrotizing fasciitis, the bacteria invade and destroy tissues underlying the skin. This causes death of the tissue as it spreads very rapidly. Approximately 500-1,500 cases occur in the U.S. each year. The important factors that determine whether a person will develop the disease are the ability of the bacteria to cause disease (virulence) and the ability of the person’s immune system to respond to the infection (susceptibility). In nearly every case of the disease, there is a skin injury first. The bacteria invade through the break in the skin and produce toxins. The toxins then invade the fascia. In some cases the bacteria continue to invade going deeper through the skin layers, even into muscle.
At first, the infected area looks red, swollen, feels hot, and is very painful. As the bacteria continue to invade over a few days, the skin may become blue-gray and blisters filled with fluid will form. The area becomes numb because the nerves are destroyed. The person may go into shock, develop a dangerously low blood pressure, as multiple organ failure can occur and death may follow.
Treatment needs to occur very quickly and aggressively with antibiotics. Surgery is frequently needed to remove the dead tissue. After surgery the patient is monitored for signs of shock and other complications. Plastic surgery may follow with skin grafts because of the deepness of the wound after removing the affected dead tissue.
Thankfully, this disease is rare but the best ways to lower the risk of contracting this disease include:
-avoid injury and breaks to the skin that may allow entry of bacteria
- if a skin injury does occur, clean the area quickly and apply antibiotic
ointment or spray
-avoid contact with anyone who is infected with the bacteria (including
those with a diagnosis of strept throat)
-have a medical doctor examine any areas that become red, swollen and
painful
Marcia Hardick, RN,BS,CSPDT
Education Advisor, NYSACSP