“Flesh-eating bacteria” refers to a severe and uncommon bacterial infection known medically as necrotizing fasciitis. This condition progresses rapidly, causing extensive tissue destruction beneath the skin.
What is Necrotizing Fasciitis?
Necrotizing fasciitis is a deep soft tissue infection that leads to the swift death of tissue, including skin, muscle, and the fascia—fibrous connective tissue. This condition is termed “necrotizing” because it causes tissue necrosis, meaning tissue death. The inflammation of the fascia is referred to as “fasciitis”.
The infection is caused by different types of bacteria. Group A Streptococcus (GAS), also known as Streptococcus pyogenes, is a frequent cause of this condition, often leading to the fastest-moving forms of the infection. Other bacteria, such as Staphylococcus aureus, Escherichia coli, Klebsiella, and Vibrio vulnificus, can be responsible, sometimes in polymicrobial infections involving multiple bacterial species. These bacteria release toxins that damage tissues and can lead to blood clots, cutting off blood supply and causing widespread tissue death.
How Infections Develop
Necrotizing fasciitis begins when bacteria enter the body through a break in the skin. This can include minor cuts, scrapes, burns, insect bites, puncture wounds, or even surgical incisions. The bacteria then spread quickly through the deep tissues, causing inflammation and destruction.
Certain factors increase an individual’s susceptibility to this infection. People with weakened immune systems or chronic health conditions, such as diabetes, liver disease, cancer, or peripheral vascular disease, face a higher risk. Those who abuse alcohol or use intravenous drugs are more vulnerable. Exposure to certain environments, like warm marine water or raw seafood, can introduce specific bacteria such as Vibrio vulnificus through open wounds or ingestion.
Identifying Symptoms
The symptoms of necrotizing fasciitis can develop rapidly, often within hours or a few days. Initially, signs may appear mild, resembling a pulled muscle or the flu, including fever, headache, and general tiredness. However, the pain is often disproportionately severe compared to the visible skin changes, and it can extend beyond the immediately affected area.
As the infection progresses, the skin around the wound may become warm, red, and swollen, with the redness spreading quickly. Later symptoms include the development of blisters, black or purple discoloration of the skin, and oozing from the infected site. Patients may experience nausea, vomiting, dizziness, and fatigue. A popping or cracking sensation may be felt when touching the skin, caused by gas produced by the bacteria.
Urgency of Medical Intervention
Immediate medical attention is necessary when necrotizing fasciitis is suspected. The infection spreads very quickly, and delays in treatment can lead to severe consequences, including sepsis, organ failure, limb amputation, or even death. The mortality rate for necrotizing fasciitis can be significant, with some individuals dying even with treatment.
Treatment involves aggressive intravenous antibiotic therapy to combat the bacteria. However, due to the rapid tissue destruction, antibiotics alone are often insufficient because they may not reach all infected areas. Therefore, urgent surgical removal of all dead and damaged tissue, known as debridement, is a primary treatment to halt the infection’s spread. In severe cases, amputation of the affected limb may be necessary to save the patient’s life.
Prevention Strategies
While necrotizing fasciitis is rare, several preventative measures can reduce the risk of infection. Thoroughly cleaning all cuts, scrapes, and other wounds with soap and water is an important first step. Afterward, cover open wounds with a clean, dry bandage.
Individuals with open wounds should avoid swimming in brackish or saltwater, as these environments can harbor bacteria like Vibrio vulnificus. Practicing good overall hygiene, including frequent handwashing, helps prevent various skin infections. Any suspicious skin infection, particularly if it involves severe pain, rapid spreading, or flu-like symptoms, warrants immediate medical evaluation.