Necrotizing Fasciitis (Flesh-Eating Disease)

  • Medical Author:
    Charles Patrick Davis, MD, PhD

    Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

  • Medical Editor: Melissa Conrad Stöppler, MD
    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

Bacterial Infections 101 Pictures Slideshow
Discover the causes, symptoms and treatment of a flesh-eating bacterial infection (necrotizing fasciitis).

What Is a "Flesh-Eating" Bacterial Infection?

What Are Early Symptoms of Flesh-Eating Disease?

The early stage of necrotizing fasciitis is characterized by symptoms of

  • redness,
  • swelling, and
  • pain in the affected area.
  • Blisters may be seen in the involved area of skin.
  • Fever, nausea, vomiting, and other flu-like symptoms are common.

Quick GuideBacterial Infections 101: Types, Symptoms, and Treatments

Bacterial Infections 101: Types, Symptoms, and Treatments

Necrotizing fasciitis (flesh-eating disease) facts

  • Necrotizing fasciitis refers to a rapidly spreading infection, usually located in fascial planes of connective tissue that results in tissue death (necrosis).
  • Different types of bacterial infection can cause necrotizing fasciitis.
  • The majority of cases begin with an existing infection, most frequently on an extremity or in a wound.
  • Necrotizing fasciitis is a serious condition that is often associated with sepsis and widespread organ failure.
  • Treatment of an infection caused by flesh-eating bacteria involves rapid antibiotic administration and/or surgical debridement of the wound areas as well as supportive measures such as insertion of a breathing tube, intravenous administration of fluids, and drugs to support the cardiovascular system.
  • Good hygiene and wound care can reduce the chance of developing the disease; necrotizing fasciitis is not usually contagious but it is possible to transmit infectious agents to other people (cross-contaminations of wounds, for example).
  • Immunosuppressed individuals (for example, diabetics, elderly, infants, those with liver disease, alcoholics, or those taking immunosuppressive drugs such as chemotherapy for cancer) are at higher risk to develop the disease.
  • The prognosis depends on how fast the infection is diagnosed and treated and the patient’s response to treatments; outcomes usually range from fair to poor with complications including tissue loss and or amputation of limbs.

What is necrotizing fasciitis?

Necrotizing fasciitis is a term that describes a disease condition of rapidly spreading infection, usually located in fascial planes of connective tissue that results in tissue necrosis (dead and/or damaged tissue). Fascial planes are bands of connective tissue that surround muscles, nerves, and blood vessels. Fascial planes can bind structures together as well as allow body structures to slide over each other effectively. The disease occurs infrequently, but it can occur in almost any area of the body. Although many cases have been caused by group A beta-hemolytic streptococci (Streptococcus pyogenes), most investigators now agree that many different bacterial genera and species, either alone or together (polymicrobial infections), can cause this disease. Occasionally, mycotic (fungal) species cause necrotizing fasciitis.

Historically, several people described this rapidly advancing condition in the 1840s to 1870s; however, Dr. B. Wilson first termed the condition “necrotizing fasciitis” in 1952. It is likely that the disease had been occurring for many centuries before it was first described in the 1800s. Currently, there are many names that have been used loosely to mean the same disease as necrotizing fasciitis: flesh-eating bacterial infection or flesh-eating disease; suppurative fasciitis; dermal, Meleney, hospital, or Fournier's gangrene; and necrotizing cellulitis. Body regions frequently have the term necrotizing placed before them to describe the initial localization of necrotizing fasciitis (for example, necrotizing colitis, necrotizing arteriolitis), but they all refer to the same disease process in the tissue. Important in understanding necrotizing fasciitis is the fact that whatever the infecting organism(s), once it reaches and grows in connective tissue (fascial planes), the spread of the infection can be so fast (investigators suggest some organisms can progress to involve about 3 centimeters of tissue per hour) that the infection becomes difficult to stop even with both antimicrobial drugs and surgery. Fortunately, this disease is relatively rare; various statistical sources estimate about 500 to 1,500 individuals are reported to have the disease per year in the U.S.

Mortality (death) rates have been reported as high as 75% for necrotizing fasciitis associated with Fournier's (scrotal) gangrene, but the mortality in patients with the infection in other regions of the body (for example, legs or arms) is about 25%. Patients with necrotizing fasciitis have an ongoing medical emergency that often leads to death or disability if it is not promptly and effectively treated.

Picture of necrotizing fasciitis (flesh-eating disease)
Picture of necrotizing fasciitis (flesh-eating disease) in the lower leg
Medically Reviewed by a Doctor on 3/17/2016

Subscribe to MedicineNet's Newsletters

Get the latest health and medical information delivered direct to your inbox!

By clicking Submit, I agree to the MedicineNet's Terms & Conditions & Privacy Policy and understand that I may opt out of MedicineNet's subscriptions at any time.

  • Necrotizing Fasciitis - Cause

    What was the cause of your necrotizing fasciitis?

    Post View 11 Comments
  • Necrotizing Fasciitis - Treatments

    What was the treatment for your necrotizing fasciitis?

    Post View 2 Comments
  • Necrotizing Fasciitis - Signs and Symptoms

    What were the signs and symptoms of necrotizing fasciitis in you or someone you know?

    Post View 2 Comments
  • Necrotizing Fasciitis - Diagnosis

    Please describe how you came to be diagnosed with necrotizing fasciitis.

    Post View 1 Comment
  • Necrotizing Fasciitis - Experience

    Please describe your experience with necrotizing fasciitis.

    Post View 3 Comments

Health Solutions From Our Sponsors