Necrotizing soft tissue infection
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.
Necrotizing fasciitis; Fasciitis - necrotizing; Flesh-eating bacteria; Soft tissue gangrene; Gangrene - soft tissue
Many different types of bacteria can cause this infection. A very severe and usually deadly form of necrotizing soft tissue infection is due to the bacteria Streptococcus pyogenes, which is sometimes called "flesh-eating bacteria" or strep.
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. With flesh-eating strep, the bacteria also make chemicals that block the body's ability to respond to the organism. As the tissue dies, the bacteria enters the blood and rapidly spreads throughout the body.
Symptoms may include:
Other symptoms may include:
Exams and Tests
The health care provider may be able to diagnose this condition by looking at your skin. Or, the condition may be diagnosed in an operating room by a surgeon.
Tests that may be done include:
Treatment is needed right away to prevent death. You'll likely need to stay in the hospital. Treatment includes:
Other treatments may include:
How well you do depends on:
This disease commonly causes scarring and skin deformity.
Death can occur rapidly without proper treatment.
Complications that may result from this condition include:
When to Contact a Medical Professional
This disorder is severe and may be life threatening. Contact your provider right away if symptoms of infection occur around a skin injury, including:
Always clean the skin thoroughly after a cut, scrape, or other skin injury.
Fitzpatrick JE, High WA, Kyle WL. Necrotic and ulcerative skin disorders. In: Fitzpatrick JE, High WA, Kyle WL, eds. Urgent Care Dermatology: Symptom-Based Diagnosis. Philadelphia, PA: Elsevier; 2018:chap 14.
Pasternack MS, Swartz MN. Cellulitis, necrotizing fasciitis, and subcutaneous tissue infections. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases, Updated Edition. 8th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 95.
Stevens DL, Bisno AL, Chambers HF, et al. Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the Infectious Diseases Society of America. Clin Infect Dis. 2014;59(2):e10-e52. PMID: 24973422 www.ncbi.nlm.nih.gov/pubmed/24973422.
Review Date: 11/3/2017
Reviewed By: David L. Swanson, MD, Vice Chair of Medical Dermatology, Associate Professor of Dermatology, Mayo Medical School, Scottsdale, AZ. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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