Necrotizing Faciitis by CDC  Richard R Facklam, PhD

Necrotizing fasciitis is a flesh eating bacterial strep infection. It originates from the Group A Strep which is the same bacteria that causes strep throat. It is a bacteria that breaks releases toxins and enzymes that break down fats, soft tissue, and the fascia or tissue covering the muscles. It can interfere with blood flow the blood flow to tissue and directly kill it. It is a very rare but serious condition. The CDC estimates that there are between 9,000 to 11,500 cases a year. Out of these, the invasive strep is responsible for 1,000 to 1,500 deaths.

You can get necrotizing fasciitis from another person via contact usually through on open wound. It can also be obtained after a minor trauma, c-section, and intestinal surgery. Vibrio vulnificus received in an open wound via ocean water can cause necrotizing fasciitis and sepsis. I participated in disaster relief in Lafayette, La. after Katrina, and this is where I first learned about this flesh eating bacteria. Out of the 22 cases reported 82% where of the vibrio vulnificus strain. It can also be acquired after the handling of sea animals with an open wound. Those with chickenpox, impaired immune systems, or chronic diseases are more susceptible.

Symptoms can include painful swollen pus-filled skin or lymph nodes including gangrenous lesions. Other symptoms can include fever, sweating, chills, profound weakness, nausea, vomiting, diarrhea, and finally shock. This infection can spread very quickly and become life threatening. It can lead to organ failure and even death. Treatment consist of powerful broad spectrum antibiotics including penicillin, vancomycin, and clindamycin along with donor antibodies to treat the bacteria. This is given in conjuction with surgery to drain lesions, remove dead tissue, and prevent the spread of the infection. If the infection is determined to be anaerobic type, the patient may be treated with a 100% oxygen in a hyperbaric chamber. I had a patient that came in with an abscessed tooth. She had a small dark spot on her neck. Over a 12 hour period it had almost became dime sized. I notified her physician and he came in immediately to diagnose her with necrotizing fasciitis, a flesh eating strep that was rapidly spreading. He scheduled her for emergency surgery to remove the necrotic tissue. This is how quickly this flesh eating strep can spread and how very serious this should be taken.