Necrotizing fasciitis, often referred to as 'flesh-eating disease,' is a severe skin infection primarily caused by group A streptococcus bacteria, leading to rapid tissue destruction. Early symptoms include severe pain, redness, and flu-like symptoms, with advanced symptoms resulting in severe complications such as drop in blood pressure and unconsciousness. Immediate treatment involving antibiotics, surgery, and possibly hyperbaric oxygen therapy is crucial to prevent mortality, along with proper wound care and hygiene to prevent infection.

1. SEGi College Sarawak
FACULTY OF NURSING & ALLIED HEALTH
Foundation in Science
Necrotizing Fasciitis
By Darrell Nadeng Dominic

2. • Necrotizing Fasciitis is commonly known
as “Flesh-eating disease” or “Flesh-eating
bacteria syndrome”, is a RARE infection of
the deeper layers of the skin and
subcutaneous tissues. It can destroy
muscles, skin and underlying tissue.
• “Necrotizing” refers to something that
causes body tissue to die.

3. What causes Necrotizing
Fasciitis?

4. Necrotizing Fasciitis is commonly caused by Group A
Streptococcus (GAS) bacteria, which is the same type
of bacteria that causes strep throat. However, several
types of bacteria, such as staphylococcus have also be
associated with this disease.

5. An individual with Strep Throat

6. How do you obtain
Necrotizing Fasciitis??

7. • The bacteria that causes Necrotizing Fasciitis
can enter the body following surgery or injury.
They can also enter the body through :
- Minor cuts
- Insect Bites
- Abrasions
• In some cases, it is unknown how the
infection began. Once the infection takes
place, it rapidly destroys muscles, skin and
fat tissue.

8. The Symptoms

9. • Increasing pain in the general area of a minor
cut, abrasion, or other skin opening.
• Pain that is worse than would be expected from
the appearance of the cut or abrasion.
• Redness and warmth around the
wound, through symptoms can begin at other
areas of the body.
• Flu-like symptoms such as
diarrhea, nausea, fever, dizziness, weakness, an
d general malaise.
• Intense thirst due to dehydration

10. More advance symptoms occur around the
painful infection site within three or four days
of infection. They include :
• Swelling, possibly accompanied by a purplish
rash.
• Large, violet-colored marks that transform into
blisters filled with dark, foul-smelling liquid.
• Discoloration, peeling, and flakiness as tissue
death (gangrene) occurs.

11. Critical symptoms, which often
occur within four to five days of
infection, include :
• Severe drop in blood pressure
• Toxic shock
• Unconsciousness

12. Caucasian with necrotizing fasciitis. The left
leg shows extensive redness and necrosis.

13. Diagnosis of Necrotizing
Fasciitis

14. • Diagnosis is often based on advance symptoms,
such as the presence of gas bubbles under the
skin. Laboratory analysis of fluid and tissue
samples is done to identify the particular
bacteria that are causing the infection.
Treatment however, begins before the bacteria
are identified.
• Household members and others who have had
close contact with someone with necrotizing
fasciitis should be evaluated if they develop
symptoms of an infection.

15. Free air in the soft tissues due to necrotizing
fasciitis

16. Necrotizing fasciitis causing air in soft tissues

17. Micrograph of necrotizing fasciitis, showing necrosis
(center of image) of the dense connective
tissue, i.e. fascia, interposed between fat lobules (top-right
and bottom-left of image).

18. Treatments for Necrotizing
Fasciitis

19. Immediate treatment is needed to prevent
death
• Powerful, broad-spectrum antibiotics given
immediately through a vein (IV)
• Surgery to drain the sore and remove
dead tissue
• Special medicines called donor
immunoglobulin's (antibodies) to help fight
the infection in some cases

20. Other treatments may include :
• Skin grafts after the infection goes away to help
your skin heal and look better
• Amputation if the disease spreads through an
arm or leg
• 100% oxygen at high pressure (hyperbaric
oxygen therapy) for certain types of bacterial
infections

21. Necrotic tissue from the left leg is being
surgically debrided in a patient with necrotizing
fasciitis

22. The left lower limb after extensive debridement

23. Prevention

24. • Keep all wounds clean and watch closely
for any signs of infection. Early detection
and treatment of infection may be the best
measure to prevent the subsequent
development of necrotizing fasciitis.
Promptly seek medical care if any signs or
symptoms of infection appear.

25. • Maintaining good personal hygiene and
frequent hand washing can prevent
infection and help control the spread of
infection. Following guidelines of proper
sterile surgical technique and practicing
strict barrier (gloves, gowns, masks, etc.)
and isolation precautions in hospitals can
also allow health care personal prevent
the development and spread of infection.

26. Aimee Copeland - aged 24
Survivor of Necrotizing Fasciitis

27. A 23 year-old woman developed a left facial cellulitis which progressed
relentlessly with necrosis. Debridement was performed on several occasions
to halt the spread of the necrosis. The ophthalmic team was consulted 10 days
after her admission because of left ptosis. Examination revealed poor ocular
movement, an urgent CT scan revealed cavernous sinus thrombosis. She was
given anti-thrombotic treatment by the medical team. The facial defect was
later reconstructed with myocutaneous graft from the thigh by the plastic team.

28. Conclusion?