is a severe type of tissue infection that can involve the skin, subcutaneous fat, the muscle sheath (fascia), and the muscle. It causes gangrenous changes, tissue death, systemic disease, and frequently results in the death of the patient.

Necrotizing fasciitis can develop when bacteria enter the body, usually through a minor skin injury or abrasion. The bacteria begin to grow and release toxins that:

• Directly kill tissue
• Interfere with the blood flow to the tissue
• Digest materials in the tissue which then allows the bacteria to spread rapidly
• Cause widespread systemic effects, such as shock

Necrotizing fasciitis (commonly referred to as a flesh eating bacteria) is a form of subcutaneous infection that can be caused by a variety of bacteria including both oxygen-using bacteria (aerobic) and oxygen-avoiding bacteria (anaerobic). A very severe and usually fatal fasciitis is caused by a virulent species of streptococcus.

Warning Signs and Symptoms of Necrotizing Fasciitis

The first sign of necrotizing fasciitis may present as a reddish, painful spot or bump on the skin. Swelling and pain may develop. The affected area will change to a painful bronzed or purplish patch that expands rapidly. The area may swell. The skin may break open. Blisters filled with blackish fluid may form in the infected area. The area may become purple and black and dead (necrotic). Expansion of the infection may become noticeable.

Systemic symptoms may include disproportionate pain, fever, sweating, chills, nausea, dizziness, thirst, profound weakness. As the infection spreads, the blood pressure drops, the patient will go into toxic shock, and will become unconscious. Without treatment, death can occur rapidly.

• Severe pain in the area
• Swelling in the area
• Discoloration of the area
• Bleeding into the skin
• Visible dead (necrotic) tissue
• Skin death, patch
• Skin breaks (open wound)
• Skin around the wound feels hot and looks reddened, raised, or discolored (inflamed)
• Oozing fluid ranging from yellowish clear or yellowish bloody to puslike in quality
• Fever
• Generally ill feeling (malaise)

Diagnosis of Necrotizing Fasciitis

Early diagnosis and treatment are critical in cases involving necrotizing fasciitis. Following the onset of symptoms, a physician can consider the patient’s medical history, perform a physical exam to check for signs of infection, and recommend certain diagnostic tests. The presence of several of the warning sings and symptoms listed above, together with gangrenous and necrotic changes (black or dead tissue) around the area of infection, should raise the need to rule out necrotizing fasciitis. Imaging tests, such as CT scans, are sometimes helpful. A Gram stain and culture of drainage or tissue from the area may reveal the causative bacteria.

Treatment for Necrotizing Fasciitis

The immediate administration of powerful, broad-spectrum antibiotics is the first step in the treatment of necrotizing fasciitis. The antibiotics are generally administered intravenously (in a vein) in order to attain a sufficiently high blood level of the antibiotic to control the infection. Medications to raise blood pressure, blood, and anti-globulins may need to be administered at the same time. If the infecting organism is an oxygen-avoiding bacteria (anaerobe), a hyperbaric oxygen chamber may be used to expose the bacteria to 100% oxygen at several atmospheres of pressure. Surgery is performed to open and drain infected areas and to remove (debride) dead tissue. Skin grafts may be required after the infection is cleared. If the infection is in a limb and cannot be contained or controlled, the amputation of the limb may be necessary.

Complications from Necrotizing Fasciitis

There are many factors that affect the prognosis of a patient infected with necrotizing fasciitis, including the type of infecting organism, the rate of spread, and susceptibility to antibiotics. In addition, the severity of complications from necrotizing fasciitis increases the longer the infection is present without treatment. Complications include:

• the local spread of infection with progressive tissue damage;
• the systemic spread of infection resulting in sepsis and shock;
• loss of a limb to amputation; and
• death

Medical Malpractice

If necrotizing fasciitis (which the doctor might describe as the flesh-eating disease) is detected and properly treated before it advances, the chances of survival without the more severe consequences is significantly better than if the necrotizing fasciitis is not detected and treated until it has reached a more advanced stage. Any undue delay in diagnosing or treating necrotizing fasciitis can have tragic consequences. Unfortunately, too often warning signs are ignored, and treatment is delayed. The following are among the more common forms of negligence or medical malpractice by physicians in diagnosing and/or treating patients with meningitis:

• Failing to test for necrotizing fasciitis when a patient reports warning signs or symptoms that can be caused by necrotizing fasciitis
• Delaying the diagnosis of necrotizing fasciitis
• Failing to order appropriate treatment for a patient with necrotizing fasciitis
• Failing to follow-up with the patient

If you or someone you love have suffered from serious complications of necrotizing fasciitis (commonly referred to as the flesh eating bacteria) due to the neglect of a physician or other health care provider, you should immediately contact an attorney to determine whether it may be possible to pursue a medical malpractice (or in some cases a wrongful death) lawsuit.