Necrotizing Fasciitis – A Rare Terror!

A rare disease known as necrotizing fasciitis has become infamous nowadays after a 24-year old American lady, Aimee Copeland, caught it after a zip lining mishap and is now fighting against it, with one leg lost to the disease and high chances of amputation of fingers!

Causes of Necrotizing Fasciitis

The dangerous disease called necrotizing fasciitis is rare, yet utterly aggressive and has a high mortality rate of 73%. It involves an infection by a flesh-eating bacterium and demolition of fascia, a tissue layer below the skin. The infection can also be caused sometimes by fungi. A major type of bacteria responsible for the disease is group A beta-hemolytic streptococci, which acts either independently or together with other bacteria.

Dr. Michael Lucchesi who is chief medical officer for SUNY Downstate Medical Center of Brooklyn informs that we come across fascia while eating red meat, in form of the tough gristle. It is beneath the skin and covers muscles. The infection spreads right in this area very rapidly. It also thrives in a non-air environment, i.e. when there is absence of oxygen.

Dr. Lucchesi says that many types of bacteria are responsible for causing this infection, which typically penetrate the body by way of a puncture wound (as in Aimee’s case). Aimee caught the bacteria through the cut she had because of falling from a zip line. Dr. Lucchesi observes that the creek area in Carrolton, Georgia, in which Aimee’s accident took place has abundant amount of bacteria. The bacteria also enter the body through insect bites, burns, cuts, scrapes and even surgical incision and many surgical procedures.
As such the bacteria are omnipresent, but they are especially predominant in stagnant water in which animals defecate or fish or wild animals have died.

Spread of Necrotizing Fasciitis

As per the U.S. National Library of Medicine, the bacterium starts releasing toxins and several bacterial enzymes, right after entering the skin and the toxins start destroying tissue and stop blood circulation in the infected area. Sometimes the progressing of the disease may include adjacent soft tissues too like muscles, skin and fat. Stoppage of blood supply brings down the amount of oxygen at the infection site and tissues start dying. Because of lack of blood circulation and the speed at which the infection spreads make it extremely tough to treat the condition.

Who is at High Risk?

People with pre-occurring medical conditions and weakened immunity are at high risk of catching the infection. These people include patients of diabetes, liver disease, renal failure, peripheral vascular disease, cancer, HIV infection, and those undergoing chemotherapy or taking corticosteroids. Even alcoholics and drug addicts are at high risk.

Symptoms

Symptoms of necrotizing fasciitis vary with severity and progress of the condition, though in the initial stages, there is a deceptive wellness, with no sign of any infection. Some patients may feel pain or soreness, resembling a ‘pulled muscle’. Usually the symptoms include redness, swelling, warmth and pain, resembling an external skin infection. With the progression of the disease the redness spreads fast and the skin turns dusky, dark or purplish. Blisters, skin breakdown, necrotic eschars (black scabs), hardened skin and drainage of wound may also occur. Sometimes a crackling sensation is also felt below the skin, denoting the presence of gas in the tissues. Pain and tenderness disappear afterwards because of nerve damage. If untreated, the condition may even lead to death.

Treatment

Necrotizing fasciitis is such a condition which cannot be treated at home and the patient has to be admitted to hospital in the intensive care unit. Proper administration of IV antibiotics and strict observation is important. Quick surgical debridement (excision) of infected tissue is also an ultimate treatment for necrotizing fasciitis.

Prevention

Preventive measures include appropriate care and management of wound. Wounds should be kept clean and watched closely for any symptom of infection. People already suffering from diseases should take more care. Those with liver disease should avoid seafood and direct contact with warm marine water possibly contaminated with Vibrio spp.

Sources: http://www.foxnews.com/health/2012/05/14/what-is-necrotizing-fasciitis/

http://www.emedicinehealth.com/necrotizing_fasciitis/article_em.htm