Nec Fas????

sparrow · Aug 6, 1999

Are you certain it is necrotizing fasciitis?

This is caused by a Group A Streptococcus (Streptococcus pyogenes). These bacteria are commonly found on the skin and in the throat. This same organism is what causes "strep throat" and impetigo. Necrotizing fasciitis is caused by a specially virulent, or invasive strain of the bacteria. This is the strain that may also cause Toxic Shock Syndrome. There may be as many as 15,000 cases of invasive Group A Strep (GAS) disease each year, only 5% of these are known to be necrotizing fasciitis. The people most at risk for this are those with underlying diseases: diabetes, cancer, HIV infection, etc or those with skin breaks such as a cut, surgical wound or chickenpox. Transmission is by direct contact with the respiratory secretions of an infected carrier or direct contact with an infected lesion. Many healthy people can be carriers of the disease and not have any symptoms. Transmission by indirect contact through objects or hands is more rare but has occurred (specially with health care workers). Incubation period is between 1-3 days. Communicability is greatest whit a person is ill, but asymptomatic carriers can spread bacteria. Invasive GAS disease can have many manifestations: pneumonia, surgical wound infections, deep soft tissue infections (necrotizing fasciitis), meningitis, bone and joint infections, toxic shock syndrome, sepsis associated with skin infections such as cellulitis, erysipelas, surgical wounds, or chickenpox lesions. Invasive disease can be rapidly progressing and severe. GAS is fatal in about 10-15% of patients. Spread can be reduced by good handwashing, specially after coughing or sneezing, and after caring for persons with wounds or sore throats. If this is indeed necrotizing fasciitis, patient's should be in contact isolation, staff should be wearing gloves, masks, and gowns and practice perfect handwashing. The ICP should evaluate nursing and medical staff for asymptomatic carriage of Group Strep A, through throat cultures and treat appropriately. Handwashing procedures should be reviewed carefully as should isolation procedures. Persons with nasal or throat carriage can be treated with antibiotics and may return to work after taking antibiotics for at least 24 hours but must complete the full course. And sensitivities should be done with the initial culture and antibiotics changed as appropriate. Hope this what what you wanted! I'm an ICP and have dealt with this before and found that if appropriate measures are taken, the disease is controlled.

nrsen99 · Aug 6, 1999

Thanks for the information. Yes, I'm sure that the cases that we treat are nec fas. They usually come to us with the infection. We practice perfect isolation and handwashing techniques. Our burn unit is excelent at containing and stopping this process.

fantasie · Jul 31, 2006

I found this site while looking for information on NF. I am currently a nurse who is recovering from the disease. It has been a long and painful ordeal, but could have been much worse from what I have heard. Thank you for the good information. I know this was an old thread, but maybe there will be others who find it as useful as I did. Thanks again.