Necrotizing Fasciitis

Necrotizing Fasciitis
Necrotizing Fasciitis is a rare skin-disease in which a flesh eating bacteria attacks the deep skin layers and destroys the skin cells. The disease occurs mainly in those who have weak immune system for example the ones who are suffering from cancer or diabetes. This is a chronic disease which spreads very fast once attacked by the microbes. It is treated with intravenous antibiotics along with surgical removal of the dead and damaged skin. In some cases, organ failure may also occur.

Affected Body Parts - It is infrequent and may attack any part of the body but it mainly affects the following body part-

• Fascial planes- these are connective tissues which covers muscles, blood vessels and nerves. It helps in binding the body structures together so that they can easily move over each other. This disease leads to destruction of the whole connected tissue structure and hence the disease spreads rapidly.

People Under Risk -  Those people are under risk who have-

• Weak immune system


• Serious disease of liver or kidney, cancer and diabetes.


• Wounds or cuts in skin.


• Rashes due to chicken pox or Viral fever.


• Under medications which weakens the body.

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Causes of Necrotizing Fasciitis

It is mainly caused by bacteria. Rare cases of fungal infection have also been reported. Following are the micro-organisms-

• Type I, or polymicrobial


• Type II, or group A streptococcal and Staphylococcus – Group A – Streptococcus and Staphylococcus are two strains of bacteria which cause the infection. Sometimes only these microbes attack and in some cases different bacteria are involved.


• Type III gas gangrene, or clostridial myonecrosis – Clostridium bacteria is the cause whenever gas is found in the affected tissue.

E. coli, Klebsiella, Pseudomonas, etc. are some other bacteria which leads to the inflammatory disease. As per many investigations it has been found that anaerobic bacteria damage the tissue areas and leave them hypoxic i.e. reduced amount of oxygen is left near that part of the skin. They survive better in that situation and spread the infection more rapidly.

Vibrio vulnificus is a bacteria which is responsible for the infection when someone consumes infected seafood or catches a wound in seawater.

Some other forms of bacteria are also there which causes the disease and in sometimes it is difficult to treat. According to a source, a 25 year old lady in U.S. caught the infected due to a wound and she had to get her leg amputated. Even after that there were complications as the bacteria had entered the bloodstream.

How does the bacteria infect?

• They produce toxins which weakens the immunity of the body.


• Damage tissues and/or leads to tissue hypoxia(oxygen reduction).


• The disease is not contagious but the bacteria are! If a person on whom the bacteria is inhabiting comes in contact with another person who is having a cut or bruise then he/she also gets infected.


• Symptoms/Signs-


• It usually starts with some wound or cuts and this wound doesn’t get healed as soon as a small would must.


• The infected skin show redness and gets swollen.


• Infected part of skin becomes very sensitive and pains a lot.


• Fever and chills.


• Early symptoms looks like that of cellulitis i.e. inflammation at a localized area of connected tissues.


• Later on, skin ulcers, blisters formations, necrotic black scars, gas in the tissues(caused by Clostridium).


• Fluid drainage is very common. It occurs as soon as the infection increases.


• Septic may also occur. It worsens the condition. The person may die as well. Since, the infection reaches the bloodstream due to septic, even after removing the infected part the problem doesn’t get solved.

Treatment

• Immediate hospitalization on confirmation of the disease.


• Intravenous antibiotics are given immediately as per the type of the bacteria that attacked. Some doctors believe in giving many different types of bacteria to avoid any kind of risk.


• Simultaneously, the sample of infected tissue is investigated to find out hat types of bacteria or other microbes are involved so that proper medicines can be suggested.


• A surgeon is consulted afterwards for debridement i.e. surgical removal of infected skin. Morbidity and mortality can be reduced by early help of a surgeon. On the basis of the infected part of the body, a surgeon must be consulted.


• Tests must be regularly done to check the level of infection. For septic and organ failure, immediate treatment must be provided.

Preventive Measures

• Good Hygiene.


• Diabetic, cancer patients etc. must be extra careful when injured or wounded.


• Keep away from people who carry MRSA.


• People suffering from liver infection must avoid seafood. Also, they should not go in seawater in case they are wounded or they have cuts.


• Physicians must also used sterilized techniques for treatment of already diseased and immuno-suppressed patients.


• Keep away from infected people.


• Regularly wash hands and keep yourself clean. Avoid junk food.

Preventive steps must be followed as this disease is lethal. It is extremely painful with extremely difficult treatment. A person may lose the body parts as well or in some cases he/she may die.

Necrotizing Fasciitis Pictures