Necrotizing soft tissue infection

Necrotizing soft tissue infection is a rare but very severe type of bacterial infection. It can destroy the muscles, skin, and underlying tissue. The word "necrotizing" refers to something that causes body tissue to die.

Causes

Many different types of bacteria can cause this infection. A very severe and usually deadly form of necrotizing soft tissue infection is due to the bacteria Streptococcus pyogenes, which is sometimes called "flesh-eating bacteria" or strep.

Necrotizing soft tissue infection develops when the bacteria enters the body, usually through a minor cut or scrape. The bacteria begin to grow and release harmful substances (toxins) that kill tissue and affect blood flow to the area. With flesh-eating strep, the bacteria also make chemicals that block the body's ability to respond to the organism. As the tissue dies, the bacteria enters the blood and rapidly spreads throughout the body.

Symptoms

Symptoms may include:

• A small, red, painful lump or bump on the skin that spreads
• A very painful bruise-like area then develops and grows rapidly, sometimes in less than an hour
• The center becomes dark and dusky and then turns black and the tissue dies
• The skin may break open and ooze fluid

Other symptoms may include:

• Feeling ill
• Fever
• Sweating
• Chills
• Nausea
• Dizziness
• Weakness
• Shock

Exams and Tests

Your health care provider may be able to diagnose this condition by looking at your skin. Or, the condition may be diagnosed in an operating room by a surgeon.

Tests that may be done include:

• Ultrasound

  Ultrasound

  Ultrasound uses high-frequency sound waves to make images of organs and structures inside the body.

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• X-ray or CT scan

  X-ray

  X-rays are a type of electromagnetic radiation, just like visible light. An x-ray machine sends individual x-ray waves through the body. The images...

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  CT scan

  A computed tomography (CT) scan is an imaging method that uses x-rays to create pictures of cross-sections of the body. Related tests include:Abdomin...

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• Blood tests
• Blood culture to check for bacteria

  Blood culture

  A blood culture is a laboratory test to check for bacteria or other germs in a blood sample.

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• An incision of the skin to see if pus is present
  
• Skin tissue biopsy and culture

  Skin tissue biopsy

  A skin lesion biopsy is when a small amount of skin is removed so it can be examined under a microscope. The skin is tested to look for skin conditi...

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Treatment

Treatment is needed right away to prevent death. You'll likely need to stay in the hospital. Treatment includes:

• Powerful antibiotics given through a vein (IV)
• Surgery to drain the sore and remove dead tissue
• Special medicines called donor immunoglobulins (antibodies) to help fight the infection in some cases

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

  Amputation

  Leg or foot amputation is the removal of a leg, foot or toes from the body. These body parts are called extremities. Amputations are done either by...

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• Hundred percent oxygen at high pressure (hyperbaric oxygen therapy) for certain types of bacterial infections

  Hyperbaric oxygen therapy

  Hyperbaric oxygen therapy uses a special pressure chamber to increase the amount of oxygen in the blood.

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Outlook (Prognosis)

How well you do depends on:

• Your overall health (especially if you have diabetes)
• How fast you were diagnosed and how quickly you received treatment
• The type of bacteria causing the infection
• How quickly the infection spreads
• How well treatment works

This disease commonly causes scarring and skin deformity.

Death can occur rapidly without proper treatment.

Possible Complications

Complications that may result from this condition include:

• Infection that spreads throughout your body, causing a blood infection (sepsis), which can be deadly

  Blood infection

  Sepsis is an illness in which the body has a severe, inflammatory response to bacteria or other germs.

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• Scarring and disfigurement
• Loss of your ability to use an arm or leg
• Death

When to Contact a Medical Professional

This disorder is severe and may be life threatening. Contact your provider right away if symptoms of infection occur around a skin injury, including:

• Drainage of pus or blood
• Fever
• Pain
• Redness
• Swelling

Prevention

Always clean the skin thoroughly after a cut, scrape, or other skin injury.