Necrotizing subcutaneous infection

Alternative names:

fasciitis - necrotizing; flesh-eating bacteria; infection - necrotizing subcutaneous; necrotizing fasciitis; subcutaneous infection - bacterial

Definition:

A type of tissue infection involving skin, subcutaneous fat, the muscle sheath (fascia) and the muscle. It causes gangrenous changes, tissue death, systemic disease, and frequently death.

Causes, incidence, and risk factors:

Necrotizing subcutaneous infection or fasciitis can be caused by a variety of bacteria including oxygen-using bacteria (aerobic) or oxygen-avoiding bacteria (anaerobic). A very severe and usually fatal fasciitis is caused by a virulent specie of streptococcus that is often referred to as the Flesh-eating bacteria by the press.

This type of infection develops when bacteria enter the body, usually through a minor skin injury or abrasion. The bacteria begin to grow and release toxins that:

• directly kill tissue
• interfere with the blood flow to the tissue
• digest materials in the tissue which then allows the bacteria to spread rapidly
• cause widespread systemic effects such as shock

Infection may begin as a small reddish painful spot or bump on the skin. This quickly changes to a painful bronzed or purplish patch that expands rapidly. The center may become black and dead (necrotic). The skin may break open. Visible expansion of the infection may occur in less than an hour.

Systemic symptoms may include fever, sweating, chills, nausea, dizziness, profound weakness and finally shock. Without treatment death can occur rapidly.