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Necrotizing soft tissue infection

Definition:

Necrotizing soft tissue infection is a rare but very severe type of bacterial infection. It can destroy the muscles, skin, and underlying tissue. The word "necrotizing" refers to something that causes body tissue to die.



Alternative Names:

Necrotizing fasciitis; Fasciitis - necrotizing; Flesh-eating bacteria; Soft tissue gangrene; Gangrene - soft tissue



Causes, incidence, and risk factors:

Many different types of bacteria can cause this infection. A very severe and usually deadly form of necrotizing soft tissue infection is due to Streptococcus pyogenes, which is sometimes called "flesh-eating bacteria."

Necrotizing soft tissue infection develops when the bacteria enters the body, usually through a minor cut or scrape. The bacteria begins to grow and release harmful substances (toxins) that kill tissue and affect blood flow to the area. As the tissue dies, the bacteria enters the blood and rapidly spreads throughout the body.



Symptoms:

Symptoms include:

  • Small, red, painful lump or bump on the skin
  • Changes to a very painful bruise-like area and grows rapidly, sometimes in less than an hour
  • The center may become black and die
  • The skin may break open and ooze fluid

Other symptoms can include:

  • Feeling ill
  • Fever
  • Sweating
  • Chills
  • Nausea
  • Dizziness
  • Weakness
  • Shock


Signs and tests:

Your doctor or nurse may diagnose this condition by looking at your skin. You may be diagnosed in an operating room by a surgeon.

Tests that may be done include:

  • CT scan
  • Blood tests
  • Skin tissue biopsy


Treatment:

Immediate treatment is needed to prevent death. Treatment includes:

  • Powerful, broad-spectrum antibiotics given immediately through a vein (IV)
  • Surgery to drain the sore and remove dead tissue
  • Special medicines called donor immunoglobulins (antibodies) to help fight the infection in some cases

Other treatments may include:

  • Skin grafts after the infection goes away to help your skin heal and look better
  • Amputation if the disease spreads through an arm or leg
  • 100% oxygen at high pressure (hyperbaric oxygen therapy) for certain types of bacterial infections


Support Groups:



Expectations (prognosis):

How well you do depends on:

  • Your overall health (especially if you have diabetes)
  • How fast you were diagnosed and how quickly you received treatment
  • The type of bacteria causing the infection
  • How quickly the infection spreads
  • How well treatment works

This disease commonly causes scarring and skin deformity.

Death can occur rapidly without proper treatment.



Complications:
  • Infection spreads throughout body, causing a blood infection (sepsis), which can be deadly
  • Scarring and disfigurement
  • Loss of your ability to use an arm or leg
  • Death


Calling your health care provider:

This disorder is severe and may be life threatening, so contact your health care provider immediately if symptoms of infection occur around a skin injury, including:

  • Drainage of pus or blood
  • Fever
  • Pain
  • Redness
  • Swelling


Prevention:

Always clean the skin thoroughly after a cut, scrape, or other skin injury.




Review Date: 11/22/2011
Reviewed By: Kevin Berman, MD, PhD, Atlanta Center for Dermatologic Disease, Atlanta, GA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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