Frequently described as ‘the flesh-eating disease’, why does necrotising fasciitis cause the death of some patients but not others?
The nature of the condition
The action and virulence of the necrotising fasciitis infection in itself means that, left untreated, the patient is very likely to die.
Once the bacteria which cause necrotising fasciitis reach the deep soft tissue of the body, it will start to cause the necrosis or death of the tissue it infects. As it does so, it will spread to surrounding areas and continue to destroy all in its path.
The movement of blood around the body becomes compromised and the functioning of the body’s major organs such as the liver, kidneys and heart starts to fail.
Necrotising fasciitis can be very swift moving, spreading rapidly through the body, so, unless action is taken to halt its spread, it can cause significant damage in a short space of time.
The type of bacteria
The type of bacteria causing a particular patient’s illness is also thought to influence its strength and the patient’s chance of death or survival.
Necrotising fasciitis can be caused by a number of different pathogens or bacteria such as Group-A Streptococcus, Staphylococcus and Clostridium, as well as several additional pathogens often thought to work in combination to produce the recognised effects of the condition.
Certain of these bacteria, or certain combinations, appear more likely to affect specific areas of the body and may be more virulent and life-threatening than other bacteria or combinations.
The underlying patient characteristics
The prognosis for a patient with necrotising fasciitis will also be influenced by the context and characteristics of the patient themselves and some patient groups are more likely to die from the illness than others.
Patients with diabetes are thought to be both more vulnerable to developing the illness and more likely to die from it. They may already have a weakened immune system and find it harder to combat the virulence of the infection.
Patients suffering with a variety of other pre-existing conditions such as liver problems and heart failure are also more likely to suffer a poor outcome.
Although people of all ages can contract necrotising fasciitis, the elderly are also more susceptible to the illness.
The speed of diagnosis and treatment
An absolutely key factor influencing the patient’s chances of survival, however, is the speed with which their diagnosis is achieved and treatment is initiated.
A patient developing necrotising fasciitis will need intravenous antibiotics and emergency surgery without delay.
Any delay in surgery is very likely to affect the patient’s long-term prognosis and the longer the delay, the greater the impact. Necrotising fasciitis is a highly virulent infection and the greater its hold on the patient’s body, the more likely the patient is to die.
Even where the patient survives, a delay in surgery will mean the patient is likely to suffer more infection-related tissue damage, require more extensive, invasive surgery and suffer more long-term physical and psychological problems.
Medical negligence
A failure by medical professionals to recognise the possible symptoms of necrotising fasciitis and a failure to take prompt action may be regarded as substandard care.
Where the patient suffers long-term disability and difficulties as a result, it may be appropriate to consider making a claim for compensation. The physical and emotional trauma caused both by the illness and the surgery necessary to combat it can cause significant damage to the patient and can reduce their ability to work and function independently.
A successful compensation claim can help the patient to cope with these difficulties.
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