What Is Necrotizing Fasciitis?

Have you heard of flesh-eating bacteria but are wondering what is necrotizing fasciitis? They’re the same. Here's what you should know about the symptoms.

What is necrotizing fasciitis?

Necrotizing fasciitis is a dangerous and potentially fatal skin infection. It is caused by bacteria that spreads rapidly and kills your soft tissue cells. Necrotizing fasciitis requires prompt medical treatment with antibiotics. Sometimes you need surgery to stop the spread of the bacteria.

Left untreated, the infection can lead to toxic shock syndrome, sepsis, organ failure, and death.

Doctors first described necrotizing fasciitis, originally called hospital gangrene, in 1871. It is very rare, and most people have a strong enough immune system to fight off this sort of infection.

The people who get necrotizing fasciitis usually have other health problems that compromise their immune system, such as type 1 or type 2 diabetes, cancer, kidney disease, or other severe chronic illnesses. It is rare that one person will spread necrotizing fasciitis to another.

You may know necrotizing fasciitis by its more common and sensational name: flesh-eating bacteria.

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What is flesh-eating bacteria?

Multiple types of bacteria can cause necrotizing fasciitis. They include Staphylococcus aureus (staph), E. coli, Klebsiella, Bacteroides, Clostridium, and group A Streptococcus, or group A strep.

Although group A strep is the most common type of flesh-eating bacteria, most of the infections it causes are mild and easily treated, never becoming necrotizing fasciitis.

Similarly, the other types of flesh-eating bacteria are more likely to cause other, less dangerous diseases. Some live in your body permanently, like Bacteroides, which is found in your digestive system and usually prevents more serious pathogens from causing infections.

When bacteria infect your soft tissue, however, they can become dangerous. Flesh-eating bacteria usually enter through a cut, burn, or surgical site in your skin, though some can spread from punctured organs. When that happens, the bacteria release toxins that cut off blood supply to your tissue. Because white blood cells fight infection, your immune system has no way of responding to the bacteria, and your soft tissue cells begin to die rapidly.

Necrotizing soft tissue infection

Necrotizing fasciitis is a type of necrotizing soft tissue infection, or NSTI.

Necrotizing means “causing the death of tissue.” Fasciitis refers to the fascia, or the connective tissue that surrounds the nerves, blood cells, muscles, and fat in your body. Necrotizing fasciitis is a necrotizing soft tissue infection that affects the fascia.

Other kinds of NSTIs include necrotizing adipositis, necrotizing cellulitis, and necrotizing myositis, all of which affect different soft tissues in your body. Medical researchers encourage doctors to use the umbrella term necrotizing soft tissue infection to describe any of these diseases, as the symptoms and course of treatment for all of them are similar.

Both necrotizing fasciitis and flesh-eating bacteria are more commonly used and recognized terms for necrotizing soft tissue infections.

Flesh-eating bacteria symptoms

The Centers for Disease Control and Prevention warns that initial flesh-eating bacteria symptoms can be hard to spot. Symptoms usually begin immediately after an injury or surgery and include pain or aching at the site of the wound, similar to a pulled muscle.

You may also notice swelling and a red or purplish color around the wound that rapidly expands across your skin. As the infection spreads, other symptoms include:

• Ulcers, blisters, or red lumps on your skin
• Black spots with dead skin at the center
• Grey or smelly liquid draining from a wound
• Areas around a wound that feel hot or numb
• Severe pain
• Fever, chills, and excessive sweating
• Lightheadedness or confusion
• Vomiting
• Fatigue

If you have those symptoms after an injury or surgery, you should seek medical attention immediately, as the window for successfully treating flesh-eating bacteria is very narrow.

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