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Necrotizing fasciitis: what it is, symptoms and treatment

Updated in July 2019

Necrotizing fasciitis is a rare and serious bacterial infection in which there is inflammation and death of the tissue that lies beneath the skin and involves the muscles, nerves and blood vessels called fascia. This infection occurs mainly by group A Streptococcus bacteria, being more frequent due to Streptococcus pyogenes.

The bacteria can spread rapidly, causing symptoms that have a very rapid evolution, such as fever, appearance of red and swollen region in the skin and that evolves to ulcers and darkening the region, for example. Therefore, in the presence of any sign indicative of necrotizing fasciitis, it is important to go to the hospital for treatment to be started and therefore avoid complications.

Necrotizing fasciitis: what it is, symptoms and treatment

Symptoms of Necrotizing fasciitis

The bacteria can enter the body through openings in the skin, whether due to injections, use of drugs in the vein, burns and cuts, for example. From the moment the bacteria enters the body, it spreads rapidly, leading to the appearance of symptoms that progress quickly, the main ones being:

  • Red or swollen regions on the skin, that increase over time;
  • Intense pain in the red and swollen regions, and it may also be noticeable in other parts of the body;
  • Fever;
  • Emergence of ulcers and blisters;
  • Darkening of the region;
  • Diarrhea;
  • Nausea;
  • Presence of pus in the wound.

The evolution of the symptoms indicate that the bacterium is multiplying and causing the death of the tissue, called necrosis. Therefore, if you notice any sign that may indicate necrotizing fasciitis, it is important to go to the hospital for the diagnosis and treatment.

Although group A Streptococcus can be found naturally in the body, necrotizing fasciitis does not occur in all people. This infection is more common in diabetics, people with chronic or malignant diseases, age over 60, obesity, who use immunosuppressive drugs or who have vascular diseases.

Possible complications

The complications of necrotizing fasciitis occur when the infection is not identified and treated with antibiotics. So, there may be sepsis and organ failure, since the bacteria can reach other organs and develop there. In addition, due to tissue death, there may also be a need for removal of the affected limb, for example, in order to prevent the spreading of the bacteria and the occurrence of other infections.

How is the diagnosis reached

The diagnosis of necrotizing fasciitis is done by observing the signs and symptoms you present, in addition to the results of the laboratory tests. Blood and imaging tests are usually ordered for observation of the affected region, in addition to tissue biopsy, which is important to identify the presence of the bacteria in the region.

Although it is recommended that treatment with antibiotics should only be started after the result of the laboratory examination, in the case of necrotizing fasciitis the doctor initiates the treatment even without the result of the examination, because as this infection has a rapid evolution, it is important that the treatment be started as soon as possible.

How to treat

The treatment of necrotizing fasciitis should be done in the hospital, and it is recommended that the person remain in isolation for a few weeks so that there is no risk of transmission of the bacteria to others.

Treatment is done with the use of antibiotics directly into the vein to fight infection. However, when the infection is already more advanced and there are signs of necrosis, it may be indicated by the doctor performing surgery to remove the tissue and thus fight the infection.


Bibliografia

  • CDC. Necrotizing Fasciitis: All You Need to Know. Link: <www.cdc.gov>. Access in 04 Jun 2019
  • PUVANENDRAN, Rukshini; HUEY, Jason C. M.; PASUPATHY, Shanker. Necrotizing fasciitis. Canadian Family Physician . Vol 55. 981-987, 2009
  • NHS UK. Necrotising fasciitis. Link: <www.nhs.uk>. Access in 04 Jun 2019
  • SOARES, Thiago H. et al. Diagnóstico e tratamento da Fasciíte Necrotizante (FN): relato de dois casos. Revista Médica de Minas Gerais. Vol 18. 2 ed; 130-140, 2008
  • COSTA, Izelda Maria C et al. Fasciíte necrosante: revisão com enfoque nos aspectos dermatológicos. An bras Dermatol. Vol 79. 2 ed; 211-224, 2004
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