With just 500 cases in the UK each year, necrotising fasciitis is a rare bacterial infection. In this article we take a look at the history of necrotising fasciitis, including when the first case was recorded.
First case of necrotising fasciitis
Throughout history, there are many recordings of people suffering flesh-eating diseases, many of which sound very similar to necrotising fasciitis. The first dates back to the 5th century B.C when Hippocrates describes a complication of cellulitis, during which the flesh fell away in large quantities. Around 2,600 cases were also reported by Joseph Jones during the American civil war. However, it was not until 1952 that the term ‘necrotising fasciitis’ was coined by Dr B Wilson.
First case of Fournier’s Gangrene
There are also many historical accounts of Fournier’s Gangrene, which is when necrotising fasciitis occurs in the male genitalia. The condition was first reported by Baurienne in 1764, who described rapid necrosis of the soft tissue surrounding the male genitalia. The same disease was later studied in 1883 by Jean-Alfred Fournier, a French venereologist.
Fournier examined five previously healthy men who suddenly developed perineal gangrene. He noted the disease was associated with high alcohol consumption, diabetes and trauma. In light of the research he undertook, necrotising fasciitis that appears in the male genitalia was called Fournier’s gangrene, and still is to this day.
Necrotising fasciitis and modern medicine
Without the help of modern medicine, a case of necrotising fasciitis would often result in death. Nowadays it is possible to make a full recovery, but only if treatment is given in a timely fashion. Intravenous antibiotics must be administered and all the necrotic tissue must be surgically excised.
Debridement surgery is the only way to fully rid the body of the bacteria and so kill the infection. More than one operation may be required to ensure all of the necrotic tissue has been cut away. If a large area of tissue must be removed, the patient may go into shock or suffer other complications such as organ failure. Most will need to be cared for in the intensive care unit. Medical processes such as VAC assisted closure and skin grafts may also be needed.
Delayed treatment of necrotising fasciitis
Necrotising fasciitis is rare, and it is possible that a medical practitioner will not encounter a case during the course of their career. Despite this, it should be possible to reach an accurate diagnosis by sending cultures to the laboratory for testing. Medical practitioners should know to order further tests as a patient will undoubtedly be displaying symptoms of a serious infection. If there is a failure to do so, there will be grounds for a medical negligence claim.
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