Necrotizing Fasciitis

Necrotizing fasciitis is a severe bacterial infection that destroys tissue beneath the skin. The bacteria spread quickly along the thin layer of tissue that covers muscles called the fascia. This creates toxins that damage tissue, cut off blood flow, and kill healthy cells.

The infection progresses rapidly and can become life-threatening within hours. It requires immediate medical attention and emergency surgery to remove dead tissue. Early detection and treatment are critical to prevent serious complications, organ failure, and death.

While often called flesh-eating disease, the bacteria do not actually eat tissue. Instead, they release harmful substances that cause tissue death. The condition is rare but extremely serious. It can affect anyone, though certain risk factors increase your chances of developing it.

• Severe pain that seems worse than what the injury or wound looks like
• Red, warm, swollen skin that spreads quickly
• Fever, chills, and feeling very ill
• Purple or black discoloration of the skin as tissue dies
• Blisters, bumps, or black spots on the skin
• Pus or oozing from the infected area
• Dizziness, weakness, and confusion
• Nausea, vomiting, and diarrhea
• Rapid heart rate and low blood pressure

Early symptoms can look like minor infections or bruises. Pain is often the first and most important warning sign. The pain is typically much more intense than the visible injury would suggest.

Necrotizing fasciitis happens when bacteria enter the body through breaks in the skin. Common entry points include cuts, scrapes, burns, insect bites, surgical wounds, and puncture wounds. Several types of bacteria can cause this infection. Group A Streptococcus is the most common, but other bacteria like Klebsiella, Clostridium, and E. coli can also trigger it. Sometimes multiple bacteria work together to cause the infection.

People with weakened immune systems face higher risk. Diabetes, cancer, kidney disease, liver disease, and HIV reduce your ability to fight infections. Chronic conditions that affect blood flow, like peripheral artery disease, also increase risk. Other risk factors include recent surgery, IV drug use, obesity, and heavy alcohol use. However, healthy people can develop necrotizing fasciitis too. Any injury that breaks the skin can potentially allow bacteria to enter and spread.

Doctors diagnose necrotizing fasciitis through physical examination, blood tests, and imaging studies. Blood tests show signs of severe infection and help calculate the LRINEC score, a tool that helps doctors assess how likely you are to have this condition. Neutrophils are white blood cells that fight bacterial infections. They rise sharply during necrotizing fasciitis as your body tries to combat the spreading bacteria. The neutrophil count is a key part of the LRINEC scoring system.

Rite Aid offers blood testing that includes neutrophil counts to help monitor infection and inflammation markers. Imaging tests like CT scans or MRI can show how far the infection has spread. However, the most definitive diagnosis comes from surgical exploration. Doctors often need to operate immediately to look at the tissue directly and remove dead or infected areas. Waiting for test results can be dangerous because the infection spreads so quickly.

• Emergency surgery to remove all dead and infected tissue, often multiple times
• High-dose intravenous antibiotics to kill the bacteria
• Hospitalization in intensive care for close monitoring
• IV fluids and medications to support blood pressure and organ function
• Hyperbaric oxygen therapy in some cases to help kill bacteria and promote healing
• Amputation of affected limbs if tissue damage is too severe
• Reconstructive surgery and skin grafts after infection is controlled
• Physical therapy and rehabilitation during recovery