In this article we explore the rare condition of necrotising fasciitis in more detail, explaining some frequently asked questions.
What is necrotising fasciitis?
Necrotising fasciitis is a bacterial infection of the body’s soft tissues. It is often dubbed the flesh-eating disease as it leads to an open wound that will expand in the absence of treatment, making it appear as though the tissue is being eaten.
What actually happens is that the bacteria enter the body and reproduce very rapidly. As they do so, the bacteria release a toxin that causes the tissue to break down. Eventually it will become so starved of blood and oxygen that the tissue dies. This is called tissue necrosis.
Who gets necrotising fasciitis?
Necrotising fasciitis is an uncommon but potentially fatal condition that can affect any part of the body. The cause of this condition is not fully understood but most patients who develop necrotising fasciitis may have a pre-existing condition which renders them susceptible to infection.
Most patients will also have sustained some form of trauma to the skin, thereby allowing the bacteria to enter the body. This can be as small as a paper cut, or as obvious as a surgical wound.
What part of the body can necrotising fasciitis develop?
Necrotising fasciitis can affect any part of the body, although the extremities (feet and hands), perineum and trunk areas are most commonly involved. When necrotising fasciitis develops in the male genitalia, it is also referred to as Fournier’s Gangrene.
What are the symptoms of necrotising fasciitis?
Necrotising fasciitis will initially cause a fever and an intense pain at the site of infection that is disproportionate to the injury sustained, if an injury is even visible. As the infection progresses, the skin will become increasingly red and hot to touch. It will gradually change in colour from red to purple/blue and will be covered in pus-filled blisters called bullae. After this the tissue will become necrotic and turn black, after which an open wound will develop.
What are the clinical signs of necrotising fasciitis?
Aside from the symptoms described above, there are a number of clinical signs that indicate necrotising fasciitis. A patient will have a raised white blood cell count, low blood pressure and a high temperature. These all signal a serious infection. The skin will also be inflamed with erythema (redness) and gradual discoloration. Subfascial fluid will be visible with an ultrasound.
Diagnosing necrotising fasciitis
A patient who presents with the symptoms described above should be suspected of having a serious infection. Tests should be carried out and will reveal the clinical indicators of necrotising fasciitis, confirming the presence of infection. Swabs should then be sent to the laboratory for testing and this will verify necrotising fasciitis.
If medical practitioners fail to diagnose necrotising fasciitis, despite the symptoms and clinical signs being present, there will be a case of medical negligence.
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