When you get a small wound, it's normal for it to fester a little and heal in a few days. But have you ever heard of a serious, life-threatening infection that starts from a small wound and gradually melts away the flesh? That's one of those dangerous conditions we're going to talk about today, called Necrotizing Fasciitis. Some people also call it the Flesh-Eating Disease.
What is Necrotizing Fasciitis?
Simply put, Necrotizing Fasciitis is a very serious bacterial infection that spreads very quickly and can even lead to death. The word 'necrotizing' means 'causing something else to die'. 'Fasciitis' refers to inflammation of the fascia.
Now you might be wondering what fascia is. It is a membrane-like tissue that surrounds muscles, nerves, fat, and blood vessels under our skin. To be precise, this is a subcutaneous tissue.
Necrotizing Fasciitis is a type of infection called Necrotizing Soft Tissue Infection (NSTI). This NSTI includes other infections, such as Necrotizing Myositis (infection that causes muscle death) and Necrotizing Cellulitis (infection that causes the cells under the skin to die).
Are there types of Necrotizing Fasciitis?
Yes, there are mainly two types:
1. Polymicrobial or Type I: This is caused by more than one type of bacteria. In most cases, both aerobic and anaerobic bacteria are involved in the infection.
2. Monomicrobial or Type II: This is usually caused by a single type of bacteria. Most often, it is caused by the bacteria ``Group A Streptococcus`` or ``Staphylococcus aureus``.
Who is most likely to develop this disease?
Some people are at higher risk of developing ``Necrotizing Fasciitis.`` Let's look at who they are:
- People with skin wounds or wounds on mucous membranes (e.g. inside the mouth, nose): This includes cuts made during surgical procedures. Even a small scratch can sometimes be a problem.
- People with obesity: That is, people who are excessively fat.
- People with Diabetes Mellitus: You know that when you have diabetes, wounds heal slowly and infections develop easily. People like that are also more likely to develop this.
- People with alcohol use disorder: Excessive alcohol use is also a risk factor.
- People with weakened immune systems: This means that the body's ability to fight disease is reduced.
- People with problems with the vascular system.
- People suffering from cancer.
- Pregnant women.
How common is this disease? Is it dangerous?
Necrotizing Fasciitis is not a very common disease. According to statistics, the incidence is between 0.3 and 15 per 100,000. However, it is believed that the actual number of patients may be higher. For example, Necrotizing Fasciitis, caused by Group A strep, is reported to occur in 700 to 1,200 cases per year.
This disease is so serious that, even with treatment, about one in three people who develop it will die. That's why early treatment is so important.
What are the symptoms of Necrotizing Fasciitis?
The initial symptoms of this disease can be similar to those of a common cold, so it can sometimes be difficult to recognize at first.
Early symptoms:
- Body aches
- Fever
- Chills
- Nausea
- Diarrhea
- Severe, unbearable pain at the site of the injury. This is a very important early symptom. The pain may be much greater than the size of the injury.
Necrotizing Fasciitis is a very fast-spreading disease, so the symptoms can quickly become severe.
Later symptoms:
- Redness and discoloration of the skin at the site of the injury (dark purple, black).
- Swelling of the affected tissue.
- Unstable blood flow.
- Blisters filled with blood or yellow fluid.
- Tissue necrosis.
- Low blood pressure.
- Sepsis (blood poisoning).
The most important thing is that if you have symptoms like these, especially severe pain with a wound and skin discoloration and swelling, you should see a doctor immediately.** This infection spreads at an incredible speed.
What are the causes of this 'flesh-melting disease'?
Most often, ``Necrotizing Fasciitis`` occurs when bacteria enter your body through a cut or scratch on your skin. But sometimes it can occur without a wound on the skin, such as from something else inside your body, such as a bruise.
How bacteria can enter the body:
- Cuts, scrapes, burns.
- Insect bite wounds (e.g., a severe mosquito bite).
- Puncture wounds caused by objects such as needles.
- After surgery.
- Although the main cause is the bacteria ``Group A strep``, it can be caused by many other bacteria. Some bacteria that live in water can also cause it. This means that if you come into contact with a wound in places where there is dirty water, you are also at risk.
How do doctors diagnose this?
If your doctor suspects this 'flesh-melting disease' after examining you and listening to your symptoms, they will order some tests:
- Blood tests: For example, a complete blood count (CBC).
- Deep tissue culture: A small piece of tissue is taken from the infected area and tested to see what bacteria is present.
- Tissue biopsy: A piece of tissue is taken and examined under a microscope to determine if the tissue is dead.
- Imaging tests: A CT scan (Computed Tomography scan) may often be performed.
In addition, the doctor will perform surgery to confirm whether it is Necrotizing Fasciitis. Also, the surgery will begin with debriding the dead tissue.
How is Necrotizing Fasciitis treated?
Rapid intervention is essential to control this disease.
- Surgery: A surgical procedure called ``debriding'' is required to confirm the diagnosis and remove all dead tissue . Sometimes, a single surgery may not be enough. Several surgeries (usually about three) may be required until the infection is completely controlled.
- Antibiotics: Strong antibiotics are given intravenously (IV).
- Intravenous fluids (IV fluids): This helps maintain fluid levels in the body and stabilize blood pressure.
After surgery, skin grafts or plastic surgery may be necessary to fully heal the wounds.
What are the possible complications of this disease?
Many of the complications of ``Necrotizing Fasciitis'' are serious. They include:
- Scars
- Loss of limbs (if the infection spreads, those parts will have to be amputated)
- Toxic shock syndrome
- Sepsis (blood poisoning)
- Death
How to protect yourself from Necrotizing Fasciitis?
There is currently no vaccine for this. However, there are things you can do to reduce the risk of developing bacterial skin infections, including Necrotizing Fasciitis:
- Avoid cuts, scrapes, burns, and insect bites as much as possible.
- If you have a wound, wash it thoroughly with soap and water and cover it with a clean bandage until it heals.
- If you have deep or serious cuts or puncture wounds, see a doctor.
- Keep your hands clean by washing them with soap regularly or using an alcohol-based antibacterial hand cleaning product.
- If you have a wound or cut on your skin, do not go into swimming pools, hot tubs, or outdoor bodies of water (such as lakes, rivers).
When should you see a doctor? (A reminder)
If you have these symptoms, seek medical advice immediately:
- If the skin color has changed and the area appears to be rapidly enlarging with swelling .
- If there is unbearable pain .
- If you have a fever .
What can you expect if you develop this disease?
If you develop this disease, the best results are achieved with an early diagnosis, antibiotics, and surgery to remove the dead tissue.
Necrotizing Fasciitis is a disease that gets worse quickly, destroying your tissues and causing organ failure. Even with treatment, as mentioned earlier, about one-third of cases can die.
Often more than one surgery is required, and scarring can occur.
What is the difference between Gas Gangrene and Necrotizing Fasciitis?
Gas gangrene (clostridial myonecrosis) is a disease that affects healthy tissue, causing gas (air) to build up inside the tissue. This gas is produced as a waste product from germs. Gas can also build up in the tissue in gas gangrene and Type I Necrotizing Fasciitis. However, the types of germs that cause these two diseases are different. Gas gangrene can also affect muscles.
Where in the body is necrotizing fasciitis most commonly seen?
This is most commonly seen in the hands and feet, especially if you have diabetes, as it is more likely to develop in the legs (especially the feet and toes).
In addition, this disease can occur in the genitals and head and neck area.
Can you survive if you develop Necrotizing Fasciitis?
Yes, you can live. The most important thing is to recognize the disease early and start treatment as soon as possible. The longer it is delayed, the worse the situation becomes.
Is Necrotizing Fasciitis contagious?
It rarely spreads from person to person . Therefore, it is usually not necessary to give antibiotics to close contacts of the patient. However, in cases of severe infection, the doctor may recommend that close contacts of the patient take preventive antibiotics as a precaution.
How long does it take for necrotizing fasciitis to develop?
Symptoms can appear within 24 hours of you getting a scrape, cut, or insect bite. This can get worse very quickly. So keep an eye on the wound for swelling, redness, and if it gets bigger.
If you have a wound, cut, or burn, wash it thoroughly with soap and water. If you develop a fever, severe pain, and/or a rapidly spreading red or discolored area that feels warm to the touch, seek medical attention immediately. The sooner you start treatment, the better your chances of getting rid of Necrotizing Fasciitis.
Take-Home Message
Okay, so now you have a better understanding of the serious disease we talked about called ``Necrotizing Fasciitis.`` Here are some important things to remember:
- This is a very dangerous, rapidly spreading bacterial infection. It is also called 'flesh-melting disease'.
- It can start even with a small wound.
- Be very careful of symptoms such as severe pain at the site of the injury, rapid spreading redness/discoloration and swelling, and fever .
- If you have these symptoms, do not delay and see a doctor immediately. Time is the deciding factor between life and death here.
- Keeping wounds clean and practicing proper hygiene go a long way in protecting against these types of infections.
We hope this information is useful to you. Stay healthy!
` Necrotizing Fasciitis, Flesh-Eating Disease, Bacterial Infection, Skin Infection, Flesh-Eating Disease, Tissue Death, Sepsis
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