Table of ContentsView AllTable of ContentsTypesSymptomsCausesDiagnosisTreatmentPrognosisCoping
Table of ContentsView All
View All
Table of Contents
Types
Symptoms
Causes
Diagnosis
Treatment
Prognosis
Coping
Necrotizing fasciitis is a rapidly progressing infection of soft tissue. The name can be broken down into two different definitions:
This photo contains content that some people may find graphic or disturbing.See PhotoReproduced with permission from © DermNet New Zealand and © Waikato District Health Board www.dermnetnz.org 2023.
This photo contains content that some people may find graphic or disturbing.See Photo
This photo contains content that some people may find graphic or disturbing.
Reproduced with permission from © DermNet New Zealand and © Waikato District Health Board www.dermnetnz.org 2023.
Several different types of bacteria can be responsible for causing necrotizing fasciitis, and there are a few different types of the disorder, including type I, II, and III. Other names commonly used for necrotizing fasciitis include:
The condition is rare, but it progresses very quickly and if left untreated it could become severe enough to cause death. Therefore, it’s vital to seek immediate medical treatment any time symptoms of necrotizing fasciitis are present, particularly after an injury or a surgical procedure.
Types of Necrotizing Fasciitis
There are several types of necrotizing fasciitis—these include:
Necrotizing Fasciitis Symptoms
Early Symptoms
The early symptoms of necrotizing fasciitis may easily be mistaken for the common flu because the symptoms—such as general body aches, sore throat, nausea, diarrhea, and chills—are very similar.But with necrotizing fasciitis, there may be erythema (which may appear red, dark, brown, or purple), pain, and tenderness at the site of infection on the skin.
People with necrotizing fasciitis are often in pain out of proportion to how their skin looks.
Often the infection starts at:
Quickly Spreading InfectionThe infection spreads rapidly. Often, an infected area of the skin can spread as fast as an inch every hour.
Quickly Spreading Infection
The infection spreads rapidly. Often, an infected area of the skin can spread as fast as an inch every hour.
Early symptoms of the condition include:
If you have early symptoms of necrotizing fasciitis, particularly if you have recently undergone surgery, experienced an injury, or have any type of illness, it’s imperative to seek immediate medical attention.
Late Symptoms
When necrotizing fasciitis progresses to the late or advanced symptoms, a very high fever is usually involved (over 104 degrees Fahrenheit) or hypothermia (low body temperature) may occur. Dehydration can occur with constant piercing pain, and the infected skin may appear shiny, swollen, or feel hard to the touch (induration) due to swelling.
As the condition progresses, necrotizing fasciitis can cause severe symptoms, these may include:
When the pain suddenly ceases—after which it has been severe—this can be a very late sign that may indicate the nerves have begun to die in the area.
At this point, severe symptoms such as confusion, weakness, and delirium may occur. A person may lose consciousness and the infected area often swells significantly and may increase several times its normal size.
The affected area may even split open, oozing large amounts of fluid. Large blisters called bullae, which are filled with bloody or yellowish fluid or blackened necrotic lesions, may appear.
Toxic Shock SyndromeIf left untreated, necrotizing fasciitis can causetoxic shock syndrome,which causes the body’s vital organs to shut down. Without treatment, the outcome is death.
Toxic Shock Syndrome
If left untreated, necrotizing fasciitis can causetoxic shock syndrome,which causes the body’s vital organs to shut down. Without treatment, the outcome is death.
While several specific underlying causes of necrotizing fasciitis have been identified, some people are much more prone to the condition, including those with a compromised immune system.
Disorders that cause immunosuppression (a compromised immune system) include:
Necrotizing fasciitis can occur in children with chickenpox, but this happens rarely.
Underlying causes of necrotizing fasciitis include bacteria entering the skin secondarily to:
BacteriaThe type of bacteria that can cause necrotizing fasciitis may include:A StreptococcusAeromonas hydrophilaClostridiumE. coliKlebsiellaStaphylococcus aureus
Bacteria
The type of bacteria that can cause necrotizing fasciitis may include:A StreptococcusAeromonas hydrophilaClostridiumE. coliKlebsiellaStaphylococcus aureus
The type of bacteria that can cause necrotizing fasciitis may include:
Diagnosing necrotizing fasciitis can be difficult when symptoms are nonspecific—such as fever, pain, or edema—but time is of the essence. Sometimes the early symptoms appear much like other common infections (such as the flu or strep throat).
Diagnostic measures may include a visual examination of the affected area, as well as:
Surgical Exploration
Exploratory surgery is commonly employed to diagnose necrotizing fasciitis. The surgeon looks for:
Another finding includes the lack of resistance of the fascia. These signs are often definitive for a diagnosis.
When necrotizing fasciitis is suspected, the diagnostician may not wait for the lab results before starting treatment; early diagnosis and intervention are imperative to improving the survival rate for people with necrotizing fasciitis.
The treatment of necrotizing fasciitis depends on the stage of the disease, complications (such as toxic shock), and more. Standard treatment of necrotizing fasciitis may include:
Prevention
Because there is no vaccine to prevent group A strep infections (including necrotizing fasciitis), and because the prognosis of necrotizing fasciitis is poor, prevention measures are very important.
Steps that you can take to prevent the condition include:
In addition to performing good wound care and proper handwashing techniques, other preventative measures should be taken (particularly when you have open wounds) such as avoiding bodies of water.
What to AvoidIf you have an open wound avoid:Hot tubsSwimming poolsSwimming in lakes, rivers, or oceans
What to Avoid
If you have an open wound avoid:Hot tubsSwimming poolsSwimming in lakes, rivers, or oceans
If you have an open wound avoid:
The mortality rate for a person who is diagnosed with necrotizing fasciitis ranges from 24% to 34%. When a person develops complications (such as toxic shock), the mortality rate increases to 60%.
It’s important to educate yourself on aspects of the disease such as treatment options. If you are unsure about your plan of treatment, get a second opinion.
Also, reach out for emotional support. This includes talking to close friends and family members as well as employing professional help when needed, such as participating in group or individual therapy and/or support groups).
Reaching out to others who are going through similar circumstances can make a huge difference in a person’s overall outlook and subsequently lend itself to recovery. Organizations such as theNecrotizing Fasciitis Foundationcan point you in the right direction.
6 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Johns Hopkins Medicine.Muscle pain: it may actually be your fascia.Centers for Disease Control and Prevention.Clinical guidance for type II necrotizing fasciitis.DermNet NZ.What is necrotizing fasciitis?National Organization of Rare Diseases (NORD).Necrotizing fasciitis.Centers for Disease Control and Prevention.About necrotizing fasciitis.Wu L, Chung KC, Waljee JF, Momoh AO, Zhong L, Sears ED.A national study of the impact of initial débridement timing on outcomes for patients with deep sternal wound infection.Plastic and Reconstructive Surgery. 2016;137(2):414e-423e. doi:10.1097/01.prs.0000475785.14328.b2
6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Johns Hopkins Medicine.Muscle pain: it may actually be your fascia.Centers for Disease Control and Prevention.Clinical guidance for type II necrotizing fasciitis.DermNet NZ.What is necrotizing fasciitis?National Organization of Rare Diseases (NORD).Necrotizing fasciitis.Centers for Disease Control and Prevention.About necrotizing fasciitis.Wu L, Chung KC, Waljee JF, Momoh AO, Zhong L, Sears ED.A national study of the impact of initial débridement timing on outcomes for patients with deep sternal wound infection.Plastic and Reconstructive Surgery. 2016;137(2):414e-423e. doi:10.1097/01.prs.0000475785.14328.b2
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Johns Hopkins Medicine.Muscle pain: it may actually be your fascia.Centers for Disease Control and Prevention.Clinical guidance for type II necrotizing fasciitis.DermNet NZ.What is necrotizing fasciitis?National Organization of Rare Diseases (NORD).Necrotizing fasciitis.Centers for Disease Control and Prevention.About necrotizing fasciitis.Wu L, Chung KC, Waljee JF, Momoh AO, Zhong L, Sears ED.A national study of the impact of initial débridement timing on outcomes for patients with deep sternal wound infection.Plastic and Reconstructive Surgery. 2016;137(2):414e-423e. doi:10.1097/01.prs.0000475785.14328.b2
Johns Hopkins Medicine.Muscle pain: it may actually be your fascia.
Centers for Disease Control and Prevention.Clinical guidance for type II necrotizing fasciitis.
DermNet NZ.What is necrotizing fasciitis?
National Organization of Rare Diseases (NORD).Necrotizing fasciitis.
Centers for Disease Control and Prevention.About necrotizing fasciitis.
Wu L, Chung KC, Waljee JF, Momoh AO, Zhong L, Sears ED.A national study of the impact of initial débridement timing on outcomes for patients with deep sternal wound infection.Plastic and Reconstructive Surgery. 2016;137(2):414e-423e. doi:10.1097/01.prs.0000475785.14328.b2
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