Flesh-Eating Bacteria

Flesh-eating bacteria cause an extremely severe, life threatening infection of the skin called as necrotising fasciitis. It starts as a cellulitis that dissects into the fascial planes under the skin. It was first described in 1952 as necrosis of the subcutaneous tissue and fascia with relative sparing of the underlying muscle.

Group A streptococcus (Streptococcus pyogenes), Staphylococcus aureus, Clostridium perfringens, Bacteroides fragilis, Aeromonas hydrophila are the most common bacteria involved. The majority of cases harbour more than one type of bacteria.  They enter from a wound or a cut in the skin and produce a toxin that damages the fascia underneath the skin. Immunocompromised states like diabetes and cancer put you at greater risk of developing necrotising fasciitis.

Necrotising fasciitis is a severe disease of sudden onset and presents with the following symptoms:

• Very high fever
• Presence of a portal of entry of bacteria
• Severe pain
• Bullae and blisters
• Crackling sound on touching the skin

The following findings may be present on investigations:

• Elevated CPK
• X-ray, CT scan, or MRI show air in the tissue

Necrotising fasciitis progresses rapidly. The damaged tissue has to be removed surgically by a procedure called surgical debridement. The removed tissue can be sent for histopathology and microbiology testing which can confirm the diagnosis. High doses of intravenous antibiotics are also a must to save the life of the person. Without early and adequate treatment, mortality is up to 80%.