Necrotizing Fasciitis - Experience

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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 first 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 (testicular) 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
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See what others are saying

Comment from: where he became infected. He didn"t have cuts or o, Male (Caregiver) Published: August 04

My brother entered the hospital on November 15, 2013 after originally being seen in the emergency room (ER) 5 days earlier for sciatica in his left thigh. His leg swelled severely and he was rushed into surgery when he returned to the ER. A second surgery the next evening revealed the necrotizing fasciitis had spread to his left gluteal area and also had begun to enter the lower spinal canal. A lot of tissue was removed from both his leg and buttocks and he was receiving large doses of antibiotics. Showing signs of extraordinary improvement, including standing and walking in place, we were hopeful for a prolonged, but definite recovery. Unfortunately, the infection had reached his brain cavity and he died on Christmas Eve. Doctors said it was from sepsis and Klebsiella. To this day we have no idea just how

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Comment from: jen, 19-24 Female (Patient) Published: June 24

I was diagnosed with a blood clot, and 6 months later felt like I got hit by a brick wall. I was very sick but nothing was showing up. I went to the emergency room (ER) the next day because I was having some chest pains, CT showed no pulmonary embolism. I went home, sat over the weekend and went to my primary doctor on Monday. She couldn't find anything wrong with me either, and by Tuesday night my leg was starting to swell. I went to the doctor first thing Wednesday and said something is very wrong with me, please check me out again. By this time I was in septic shock and was shipped to the ER and admitted by 2 am. I was Life-Flighted because I started coding, was admitted to ICU and had 4 surgeries in a week for necrotizing fasciitis. I was sent home a few days after the 4th surgery. They had closed my wound but with so much tissue taken out, my body was not able to heal properly and I ended back in the hospital for another week to open the wound and make sure it was not getting infected again. I then had a wound to pack 2 times a day, and I did that for 2 months. When it was just about closed I got sick again, and the one hour it took me to get to the ER I was in septic shock again, then started coding again at 2 am. Central line was placed and I was taken to surgery the next morning when a 12x9 inch chunk was taken out of my thigh. I had necrotising fasciitis again, this time it was strep G bacteria. I scared all of my doctors very bad because I was healthy again and knew I was feeling so much better, about to go back to work. I had skin grafts taken off of my other thigh and ended up being in the hospital for a month with that infection. I was in and out of the hospital over the next few months for small infections. I am not back to work full time but have been diagnosed with CRPS (complex regional pain syndrome) due to all the trauma to my leg. I am having surgery every 4 to 6 months now to take the skin grafts out in hopes that the CRPS will go away once the graft is out. Now the question is when I can stop antibiotics or if I will need to be on them forever. This is a very scary and traumatic infection to get and it has really changed my prospective on life. I am very lucky to be alive and watch my baby girl grow up!

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