Also known as: Necrotizing fasciitis, Fasciitis - necrotizing, Flesh-eating bacteria, Soft tissue gangrene or Gangrene - soft tissue
- 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
- Feeling ill
- X-ray or CT scan
- Blood tests
- Blood culture to check for bacteria
- Skin tissue biopsy and culture
- Powerful antibiotics are 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
- 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
- 100% oxygen at high pressure (hyperbaric oxygen therapy) for certain types of bacterial infections
- 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
- Infection spreads throughout body, causing a blood infection (sepsis), which can be deadly
- Scarring and disfigurement
- Loss of your ability to use an arm or leg
- Drainage of pus or blood
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.
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."
Necrotizing soft tissue infection develops when the bacteria enters the body, usually through a minor cut or scrape. The bacteria begins to grow and release harmful substances (toxins) that kill tissue and affect blood flow to the area. As the tissue dies, the bacteria enters the blood and rapidly spreads throughout the body.
Symptoms may include:
Other symptoms may include:
Exams and Tests
The 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:
Treatment is needed right away to prevent death. You'll likely need to stay in the hospital. Treatment includes:
Other treatments may include:
How well you do depends on:
This disease commonly causes scarring and skin deformity.
Death can occur rapidly without proper treatment.
Complications that may result from this condition include:
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:
Always clean the skin thoroughly after a cut, scrape, or other skin injury.
Pallin DJ, Nassisi D. Skin and soft tissue infections. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 137.
Pasternack MS, Swartz MN. Cellulitis, necrotizing fasciitis, and subcutaneous tissue infections. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 8th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 95.
Stevens DL, Bisno AL, Chambers HF, et al. Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the Infectious Diseases Society of America. Clin Infect Dis. 2014;59(2):e10-52. PMID: 24973422 www.ncbi.nlm.nih.gov/pubmed/24973422.
- Review date:
- September 10, 2015
- Reviewed by:
- Kevin Berman, MD, PhD, Atlanta Center for Dermatologic Disease, Atlanta, GA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- 2008 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.