Necrotizing fasciitis

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Template:DiseaseDisorder infobox | }} Necrotizing fasciitis or fasciitis necroticans, commonly known as "flesh-eating bacteria", is a rare infection of the deeper layers of skin and subcutaneous tissues (fascia). Many types of bacteria can cause necrotizing fasciitis (eg. Group A streptococcus, Vibrio vulnificus, Clostridium perfringens, Bacteroides fragilis), of which Group A streptococcus is the most common cause.

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Pathology

The infection occasionally starts with pharyngitis (sore throat), but more often begins locally, at a site of trauma, which may be severe (such as the result of surgery), minor, or even non-apparent. The affected skin is very painful, red, hot and swollen. Skin color may progress to violet and blisters may form, with subsequent necrosis (death) of subcutaneous tissues. Patients with necrotizing fasciitis typically have a fever and appear very ill. More severe cases progress within hours, and the death rate is high.

Treatment

The diagnosis is confirmed by either blood cultures or aspiration of pus from tissue. Early medical treatment is critical. Treatment often includes intravenous penicillin, vancomycin and clindamycin. If necrotizing fasciitis is suspected, surgical exploration is always necessary, often resulting in aggressive debridement (removal of infected tissue). Amputation of the affected organ(s) may be necessary.

Prognosis

This disease is one of the fastest-spreading infections known as it spreads easily across the fascial plane within the subcutaneous tissue. For this reason, it is popularly called the "flesh-eating disease" and although rare, it became well-known to the public in the 1990s. Even under world best-care practices today, the prognosis has a mortality rate of around 20 percent. Mortality is nearly 100 percent if not properly treated. Correct diagnosis and early treatment of this disease is therefore of extreme importance.

Other bacterial strains

In April 2005, a rarer but even more serious form of the disease has been observed in increasing frequency, with several cases having been found especially in California. In these cases, the bacterium causing it was a strain of Staphylococcus aureus (i.e. Staphylococcus, not Streptococcus as stated above) which is resistant against methicillin, the antibiotic one would usually use for treatment. (See Methicillin-resistant Staphylococcus aureus for details.)

A fictional virus with symptoms like necrotizing fasciitis was featured in the modern horror film Cabin Fever.

Well-known victims

See also

External links