Necrotizing soft tissue infection


Definition

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.

Alternative Names

Necrotizing fasciitis; Fasciitis - necrotizing; Flesh-eating bacteria; Soft tissue gangrene; Gangrene - soft tissue

Causes

This EM Should be displayed at the top of the article section "Causes"

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."

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. As the tissue dies, the bacteria enters the blood and rapidly spreads throughout the body.

Symptoms

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

Treatment is needed right away to prevent death. You'll likely need to stay in the hospital. Treatment includes:

Other treatments may include:

Outlook (Prognosis)

How well you do depends on:

This disease commonly causes scarring and skin deformity.

Death can occur rapidly without proper treatment.

Possible Complications

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:

Prevention

Always clean the skin thoroughly after a cut, scrape, or other skin injury.

References

Pallin DJ, Nassisi D. Skin and soft tissue infections. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 137.

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. 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):e10-52. PMID: 24973422 www.ncbi.nlm.nih.gov/pubmed/24973422.

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