This document provides information about necrotizing fasciitis, also known as flesh-eating bacteria. It begins by defining necrotizing fasciitis as a rapidly spreading necrotizing infection of subcutaneous tissue and fascia. It then discusses the two main types, risk factors like diabetes and immunosuppression, pathophysiology where bacteria destroy tissue and impair the immune response, early clinical features like pain and swelling, advanced features like necrosis and eschar formation. It concludes by covering diagnostic tests, treatment which involves emergency debridement and IV antibiotics to prevent toxic shock syndrome and death.

1. NECROTISING
FASCITIS
ABHISHEK BHARTI
Roll no 17005

2. INTRODUCTION
• Rapidly spreading necrotising infection of
subcutaneous tissue & fascia
• Alsoknown as: “flesh-eating” bacteria.
• Infection rapidly destroy the skinand soft tissue
beneath it
• Other names: β-hemolytic streptococcal
gangrene, Meleneyulcer, acute dermal gangrene,
hospital gangrene, and necrotizing cellulitis.

3. Types of NF.
• Type I : apolymicrobial flora
• Type II Group A β-Streptococcus bacteria

4. Transmission of bacteria
• From outside due to penetrating trauma,
surgery
• From inside due to transient bacteremia

5. RISK FACTORS
• Old age
• Diabetes
• Alcoholism
• Immuno-suppression-steroids/HCV
• Severe illnesses:heart, lung, or liverdisease
• Malnourished
• Obesity

6. PATHOPHYSIOLOGY
• Bacteria eat away at tissue between skin and
muscle
• Inflammatory response by immune system
• Bacterial toxins released
• Cytokines impede function of phagocytic cells
• Anaerobes thrive speeding up necrotic process
• Endothelium damaged leading to poor blood
supply
• Poor blood supply inhibits inflammatoy
resopnse & cause hypoxia

7. EARLY CLINICAL FEATURE
• Flu like symptoms that include fever, chills,
nausea, weakness, dizziness, aches
• Skinbecomes tender, warm, red in color, and
start to swell
• Patients mayexperience pain greater than
expected from the appearance of the wound
• Subcutaneous tissue mayalso havea hard feel on
palpation

9. ADVANCE CLINICAL FEATURE
• Cellulitis changes to painful pathognomic grey
blue patch within 36 hrs
• Hard woody induration
• Violacous bullae & necrosis with thin watery
malodorous fluid appear
• Progress to deep ulceration & eschar
formation

10. • High fever with chills ,malaise,tachytardia
• Toxic shock syndrome may occur
• Lesion may become anaesthetic due to
cutaneous nerve damage
• MOST Common site are extremities

13. INVESTIGATION & DIAGNOSIS
• Blood investigation:
TLC,DLC,CPK, elevatedor lowered
creatinine, glucose, CPK, bicarbonate, albumin,
andcalcium levels
• MRI toknowdepth
• BacterialCulture & Drugsensitivity

14. TREATMENT
• Early diagnosis & treatment is vital
• Emergency debridement
• IV antibiotics
• Hyperbaric oxygen therapy for anaerobes
• Morphine drip & patient controlled analgesia
pump