Necrotizing Fasciitis (Soft Tissue Inflammation)

Written by Gretchen Holm | Published on July 13, 2012
Medically Reviewed by George Krucik, MD

Necrotizing Fasciitis

What Is Necrotizing Fasciitis?

Necrotizing fasciitis is a type of soft tissue infection. It can destroy the tissue in your skin and muscles as well as subcutaneous tissue.

Necrotizing fasciitis is most commonly caused by an infection with group A Streptococcus, commonly known as “flesh-eating bacteria.” This is the fastest moving form of the infection. When this infection is caused by other types of bacteria, it typically does not progress as quickly and is not quite as dangerous.

You can contract this infection from even a tiny cut. If you have symptoms or believe that you may have developed the infection, see a doctor immediately. Because the condition can progress quickly, it’s vital to treat it as early as possible.

What Causes Necrotizing Fasciitis?

Several types of bacteria cause necrotizing fasciitis. The most common and well-known type is group A Streptococcus. However, this is not the only type of bacteria that can cause this infection. Other causes include:

  • aeromonas hydrophila
  • clostridium
  • E. coli
  • klebsiella
  • staphylococcus aureus

To get necrotizing fasciitis, you need to have the bacteria in your body. This typically occurs when your skin is broken. For example, the bacteria can enter your body through a cut, scrape, or surgical wound. These injuries do not need to be large for the bacteria to take hold. Even a needle puncture can be enough.

You can develop necrotizing fasciitis even if you are perfectly healthy, although this is rare. According to the Centers for Disease Control and Prevention (CDC), most people who are infected already have health issues that weaken the immune system, such as HIV/AIDS (CDC, 2012).

What Are the Symptoms of Necrotizing Fasciitis?

The first symptoms of necrotizing fasciitis may not seem serious. Your skin may become warm and red, and you may feel as if you have pulled a muscle. You may even feel like you have the flu. You may also develop a painful red bump, which is typically small. However, the red bump does not stay small; the pain will become worse and the affected area will grow quickly.

There may be oozing from the infected area or it may become discolored as it decays. Blisters, bumps, black dots, or other skin lesions might appear. In the early stages of the infection, the pain will be much worse than it looks.

Other symptoms of necrotizing fasciitis include:

  • fatigue and weakness
  • fever with chills and sweating
  • nausea and vomiting
  • dizziness
  • infrequent urination

How Is Necrotizing Fasciitis Diagnosed?

In addition to looking at your skin, your doctor may perform several tests to diagnose this condition. He or she may take a biopsy (a small sample) of the affected skin tissue for examination. In other cases, blood tests or a CT scan may help your doctor make a diagnosis. A CT scan can show whether your skin has thickened. Blood tests can show if your muscles have been damaged.

How Is Necrotizing Fasciitis Treated?

Treatment begins with strong antibiotics. These are delivered directly into your veins. Unfortunately, the tissue decay means that the antibiotics might not be able to reach all of the infected areas. As a result, it’s important for doctors to remove any dead tissue immediately. In some cases, amputation of one or more limbs may be necessary to help stop the spread of the infection.

What Is the Outlook for Necrotizing Fasciitis?

The outlook for this condition depends entirely on its severity. The National Necrotizing Fasciitis Foundation estimates that more than 20 percent of people who have necrotizing fasciitis die from the condition (NNFF, 2005).

Survivors may experience anything from minor scarring to limb amputation. Your doctor will be able to give you more specific information about your individual case.

How Can I Prevent Necrotizing Fasciitis?

There is no way to prevent necrotizing fasciitis infection. However, you can reduce your risk with basic hygiene practices. Wash your hands frequently with soap and treat any wounds (even minor ones) promptly.

If you already have a wound, take good care of it. Change your bandages regularly or when they become wet or dirty. Don’t put yourself in situations where your wound could become contaminated. The CDC lists hot tubs, whirlpools, and swimming pools as examples of places you should avoid when you have a wound.

Go to your doctor or the emergency room immediately if you think there is any chance you may have necrotizing fasciitis. Treating the infection early is very important.

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