Monday, May 5, 2014

Flesh Eating Disease

Flesh Eating Disease Flesh eating disease also known as necrotizing fasciitis is an infectious disease that causes death of tissues causing organ failure. It is actually the bacteria that eat away the flesh or connective tissues cause necrosis (death of tissue). Various types of bacteria can cause this infectious disease. This infection spreads rapidly to the connective tissues of fascial planes thus destroying them. It usually starts from the existing infection.


Antibiotics are the best treatment for this disease and sometimes surgery has to be done for removing the infected part from the body. Fascial planes are connective tissues that envelop the nerves, muscles and blood vessels of our body. They are binding structures that facilitate flexible movement of the body and infection can occur on any part of the tissue.


Causes :


Flesh eating disease is caused by different types of bacteria. Predominantly streptococcus pyogenes is responsible for spreading infection on the tissues. In rare cases fungus can also cause this disease.


Type 1 infection is caused by polymicrobial bacteria and Type 2 by strep bacteria. In case gas is present in the infection Clostridium bacteria can also cause infection. In many cases non-anaerobic bacteria initially damages the tissue which leads to hypoxia (reduction of oxygen) which becomes easy base for the anaerobic bacteria to attack on them.


Symptoms :


Often, flesh eating disease or necrotizing fasciitis begins in the existing infection or wound in the body. It can be either in the hands or legs or even on the trunk. Some of the common kinds of infectious areas are wounds, cuts on the skin, surgical incisions or injury caused by insect bite etc. Once the bacteria enter into the spot it multiplies rapidly spreading the infection to the connective tissues of the organ. Now the infected area becomes swollen and red.


Some of the symptoms of necrotizing fasciitis are sharp pain, redness and swelling on the wound or site of infection accompanied by fever and chills. The skin may form ulcers or fluid filled blisters or black scabs or sometimes gas is formed inside the tissues. It may also cause oozing of yellowish pus like liquid from the infected wound. Depending on the type of bacteria the symptoms can be mild to severe. For some people, the infection begins on the deep facial planes of the connective tissue and for others it starts after minor skin injury like cuts or abrasions. In case the infection attacks the immune system the patient may develop liver problems like hepatitis or liver disease. In rare cases infants that are born prematurely are prone to develop this disease.


Risk Factors :


Any person who carries a wound or insect bite or injury on any part of the body is prone to further infection like necrotizing fasciitis. Infants, elderly people, people who are diabetic (for long periods) and people with weakened immunity disorders like cancer or AIDS and those who are undergoing chemotherapy are prone to get infection easily.


People who have undergone surgery recently particularly on their bones, joints or muscles are at high risk of getting infected. Do not delay the treatment if you suspect something is wrong since it can cause loss of organs or any other complication.


Diagnoses :


The doctor would initially examine the affected part of the body after collecting the medical history of the person. He would ask few questions about the injury or wound. Depending on the site of infection he may order for several tests. If a diabetic patient complains of intense pain with swelling and changes in skin color it can be due to Fournier’s gangrene. Once the doctor suspects an attack from bacteria he would promptly put the patient on antibiotics to prevent further complications.


Biopsy of the tissue (infected) is done for testing in the laboratory for detecting the type of organism. If the doctor suspects gas in the tissues then he may order for imaging tests like X-rays, CT or MRI scans to detect the extent of infection. In addition, complete blood test is done to detect WBC count and for studying the level of blood urea nitrogen.


Treatment :


Depending on the health condition of the patient, he will be hospitalized and put on IV fluids to start with antibiotic therapy. A combination of various antibiotics is normally used if the doctor suspects multiple bacterial infections. Report from the lab will help in detecting the type of bacteria that has caused infection and accordingly the antibiotics are administered.


Surgery :


Debridement of the tissue is done if the infection is deep. The risk of complications or death is reduced by early intervention of surgery to remove the dead tissues. If the patient is very sick and has developed organ failure or other complications he/she should be treated on emergency basis. The patient will be supplemented with breathing tube and given lot of drugs and antibiotics to prevent further growth of bacteria and death of tissues. Complete recovery of the patient depends on the organ/site infected and also on the intensity of the infection.


Prevention :


If you suspect any infection on the cuts or wounds then you should immediately start treatment with your doctor. Early therapy can prevent the person from getting flesh eating disease. You need to thoroughly check your body for any swelling or infection on the cuts/wounds. This is more important for diabetic patients who may have lost the sensation of pain. Wash your hands properly before eating any food. Follow good hygiene to prevent any type of infection.


A person whose immunity is compromised should take due care to avoid any infection since it can become severe. They should avoid seafood and uncooked meat of any kind. If you have recently undergone any surgery follow the instructions of your doctor to prevent the site from getting infected. Though flesh eating disease is not contagious still you can avoid physical contact with people who are likely to get infected with wounds, cuts or abrasions.


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