Necrotizing Fasciitis - Symptoms, Risk factors and Treatment

Necrotizing fasciitis is a disease caused by a bacterial infection that results in the death of the body's soft tissues. Necrotizing means causing tissue death and fasciitis means inflammation of the fascia- that is the connective tissue in your body. It is also known as flesh-eating disease.


What causes necrotizing fasciitis?


Necrotizing fasciitis is most commonly caused by group A streptococci.


Streptococci:


The streptococci are a group of bacteria causing different clinical diseases. They produce illnesses by releasing toxins or by a delayed antibody-mediated response, which is a condition in which your body starts hurting your own tissues while fighting off the bacteria. Streptococci are divided into different groups such as:


  • Group A Streptococci ( Streptococcus pyrogens)

  • Group B streptococci ( Streptococcus agalactiae)

  • Group D streptococci ( Enterococci and Non-enterococci)

  • Streptococcus Viridans

  • Streptococcus Pneumoniae


All these different groups produce a variety of diseases. For example, Streptococcus Pneumoniae causes pneumonia. The disease we are focusing on in this article is caused by group A streptococci. These are also called Streptococcus pyrogens which means pus-producing. This group causes a variety of diseases by local invasion or toxin release or by a delayed antibody-mediated response such as:


  • Streptococcal pharyngitis (Sore throat)

  • Folliculitis (infection of hair follicles)

  • Cellulitis ( Infection of skin cells)

  • Erysipelas (Infection of superficial skin layer)

  • Impetigo ( Blisters around the mouth)

  • Necrotizing Fasciitis ( Damage to soft tissues)

  • Scarlet fever

  • Rheumatic fever

  • Acute-post streptococcal glomerulonephritis




Risk factors for necrotizing fasciitis:


Injuries: 

Any break in the continuity of skin can provide a gateway for different microorganisms to penetrate the body. The skin serves as a barrier protecting from different infections. Any cuts or wounds can help bacteria to enter and cause infections like necrotizing fasciitis.


Lowered immunity

Any condition that causes the immune system to be suppressed causes different bacteria to infect an individual as the immune system is responsible for fighting off different infections. Conditions like AIDS, cancer chemotherapy, diabetes, etc. can predispose a person to catch infections like necrotizing fasciitis. Using steroids for the treatment of different diseases can also suppress the immune system.


Surgery: 

Surgical procedures can introduce bacteria in the body and skin because the tissues are cut open giving bacteria a good chance to make their way.


IV drug abuse: 

People who abuse intravenous drugs can get necrotizing fasciitis as repeated puncture of the skin and unhygienic conditions can introduce bacteria in the skin and body.


Signs and symptoms of necrotizing fasciitis:


The signs and symptoms of necrotizing fasciitis include:


Swelling: The lesion usually starts with swelling that is red and warm.

Pain: Swelling is accompanied by pain that may be felt beyond the affected area. Necrotizing fasciitis spreads rapidly to surrounding areas.

Fever: Other than painful swelling of the affected area, there may be fever too.


Necrotizing fasciitis needs urgent care:


Necrotizing fasciitis is a serious skin infection that spreads rapidly to other structures and causes tissue death. Therefore, every second is important and medical care must be sought immediately.


Complications of necrotizing fasciitis:


Permanent destruction of parts of the body:


Due to the infection and the surgical removal of tissues as a part of treatment, there may be permanent impairment of a limb and amputation may be needed. 


Toxic shock syndrome: 


Toxic shock syndrome is a rare, life-threatening condition caused by the release of bacterial toxins. It is mostly caused by Staphylococcus Aureus also known as Staph and Group A Streptococci. Toxic shock syndrome can result in shock and multiple organ damage.



Treatment of necrotizing fasciitis:


The treatment of necrotizing fasciitis mainly involves:


Antibiotics: 

Antibiotics are given to clear up the bacteria that are causing damage. 


Surgery:

Surgical removal is done to remove the damaged tissues and preventing the infection from spreading further. Sometimes, amputation of a limb may be needed.



Prevention of necrotizing fasciitis:


Necrotizing fasciitis can be prevented by proper wound care. If you have open wounds, keep them clean by washing with soap and water and covering them with a bandage until they heal.


Conclusion:


Necrotizing fasciitis is a skin disease that requires urgent attention. If not treated on time, severe complications can arise. If you have a history of wounds, injuries, or surgery and you observe the above-mentioned symptoms, it is highly recommended to consult your healthcare provider.


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