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What You Need to Know About Flesh-Eating Bacteria


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What causes necrotizing fasciitis (aka flesh-eating bacteria)?

Recently, it seems like a new case of flesh-eating bacteria is reported by the media every few days.  Although the infection is rare, the impact is quick, damaging and potentially deadly. 

What You Need to Know About Flesh-Eating Bacteria

It seems a new case of flesh-eating bacteria is reported in the news every few days. The stories are often similar; a short time of water play results in lengthy hospital stays, surgeries and sometimes death. Although the media refers to the infection as “flesh-eating” bacteria, there are actually several types of bacteria that can lead to serious skin infections.

The clinical condition of “flesh-eating” disease is actually necrotizing fasciitis. It is rare, serious and occurs when bacteria enters through a break in the skin. Necrotizing fasciitis quickly attacks the skin, fat and tissue covering our muscles. Toxins released by the bacteria can lead to shock and organ failure.

What causes necrotizing fasciitis?

Group A. Streptococcus is believed to be the most common cause of necrotizing wound infections according to the CDC. However, other types of bacterial infections can lead to the condition. V. vulnificus bacteria can also enter through breaks in the skin when wading or swimming in infected water. The vibrio species thrives in warm waters that stay above 55 degrees year-round. This is why reports of necrotizing fasciitis are often reported in warmer months of summer.

Where does the bacteria enter?

The bacteria can enter through any break in the skin. This includes:

  • Cuts and scrapes
  • Trauma or surgical wounds
  • Rashes
  • Burns
  • Insect or animal bites
  • Puncture wounds, including those caused by IV drug use

Why is quick diagnosis and acting fast so critical?

Necrotizing fasciitis spreads easily, rapidly and a person’s condition deteriorates in a short amount of time. The fatality rate is high, between 20 and 80 percent. The CDC reports between 700 and 1,100 cases of necrotizing fasciitis, caused by group A streptococcus, has been reported each year since 2010.

Why is such a crucial diagnosis often delayed?

In the early stages, the signs of tissue inflammation may not be noticed or attributed to other causes. The signs and symptoms of necrotizing fasciitis become more apparent as the infection worsens. They may take 3-4 days to appear and be vague- a low grade fever and general unwell feeling.

Early symptoms may include:

  • Red, hot and swollen area of skin that spreads quickly
  • Severe pain and pain extending beyond the area of red skin
  • Presence of fever

Late symptoms may include:

  • Ulcers, blisters and black spots on the skin
  • Pus or oozing drainage from the infected area
  • Dizziness and fatigue
  • Diarrhea or nausea
  • Confusion
  • Dehydration
  • Skin changes color- violet or black
  • Necrotic or gangrene skin

After 4-5 days, the infection enters the bloodstream and the person becomes critically ill. Signs of sepsis will present, including high temperature, low blood pressure and altered level of consciousness and eventually organ failure.

How is necrotizing fasciitis diagnosed?

The doctor will evaluate symptoms and assess the area of infection. These diagnostic tests can be used to make an accurate diagnosis:

  • Tissue sample (biopsy)
  • Bloodwork to evaluate for signs of infection or muscle damage
  • Diagnostic imaging of the infected area

Who is at risk?

Although necrotizing fasciitis is rare, most cases are diagnosed in someone with a weakened immune system. These include:

  • Heavy use of alcohol or drugs
  • Breaks in skin
    • Acne
    • Eczema
    • Punctures
    • Insect bites
    • Tattoos
    • Rashes
  • Older adults
  • Those with chronic illness
    • Diabetes
    • Kidney disease
    • Cirrhosis
    • Cancer
  • Recent surgery or trauma
  • Peripheral vascular disease

What is the treatment?

The first line of treatment for flesh-eating bacteria is intravenous antibiotics and surgery to remove infected tissue. Multiple surgeries may be needed in serious infections and amputations may be necessary.

Is necrotizing fasciitis contagious?

It is very rare for this condition to spread person to person.

What can I do to prevent skin infections?

Simple precautions can ward off skin infections. Keep all breaks in the skin clean and dry; covered with a dry bandage if open or draining. Good hand washing is essential for preventing infection. And, see a doctor for deep or serious wounds.

If you have an open wound, avoid:

  • Hot tubs
  • Swimming pools
  • Lakes, rivers, oceans and other bodies of water

Enjoy the Water, But Take Precautions

Necrotizing fasciitis is very rare. Your chances of getting the infection is extremely low if you are in good health and practice good hygiene. Therefore, people should not be afraid to enjoy the water. Just be sure to practice good hygiene and prevention measures.

Additional Resources

What is Flesh Eating Bacteria and How Do You Fight Them?

Necrotizing Fasciitis: All You Need to Know

Necrotizing Fasciitis Hits Fishing Florida Man

Hello! I am a nurse with over 20 years experience in a variety of settings and positions. I enjoy writing about what I encounter in my own nursing practice.

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2 Comment(s)

Thank you for bringing up that very important topic. I work in an outpatient gastroenterology clinic and I think it is prudent to mention that there are some good bacteria that can help to prevent such a life-threatening condition. The "good" bacteria or probiotics are from foods like yogurt, kefir and certain aged cheeses; they help to strengthen our immune system. I have many clients come to the office for an assessment of their gut health. When I perform a routine Organic Acids Test, the doctor and I evaluate whether or not there are dysbiosis markers present. While you were correct about the toxins from harmful bacteria overwhelming the immune system, do not forget that the "good" bacteria produce metabolites that help to strengthen and support the human body through fermentation. Probiotics make SCFA's, they help to overpopulate the harmful bacteria that have the potential to cause necrotizing fasciitis and they even produce certain vitamins. If you are ever wondering about routine tests for your patients to help ensure that they have a healthy balance of bacteria, consider an organic acids test. It can help to prevent all those cases of bacterial infections that we hear about every few days or so. Here is a link with some additional information...

Clinical Applications of Urinary Organic Acids. Part 2. Dysbiosis Markers.pdf