Flesh Eating Bacteria

delayed breast cellulitis, recurrent cellulitis, recurrent erysipelas, soft tissue infections, Dermatolymphangioadenitis (DLA), Flesh Eating Bacteria, Bacterial Infections, Strep Infections, bacterial cellulitis, prophylactic antibiotics

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Flesh Eating Bacteria

Postby patoco » Sat Jun 10, 2006 9:08 pm

Flesh Eating Bacteria

Our Home Page: Lymphedema People



Scary as it seems, I have been running into many people's websites that have had this! Oddly too, they have also lymphedema so I thought it would be a good idea to post information about it. I have invited 2 survivors, who also have lymphedema, to become members of our family.


Necrotizing fasciitis


Necrotizing fasciitis (NF) is a bacterial infection. This bacteria attacks the soft tissue and the fascia, which is a sheath of tissue covering the muscle. NF can occur in an extremity following a minor trauma, or after some other type of opportunity for the bacteria to enter the body such as surgery.

The Group A Strep infection (flesh eating bacteria) is most common with minor trauma. A mixed bacterial infection is often the cause after surgery.

We can personally tell you about people who developed NF after a C-section, after abdominal surgery, after scratching a rash, after giving birth vaginally, from a tiny scratch, after bumping a leg with a golf bag, after a friendly punch in the arm from a buddy, after a little cut on the finger, after a cut on the foot, after a rug burn, after having a routine blood draw in a physical exam, after a broken arm, and after a broken leg, and from no known trauma at all.

In order for someone to contract NF, the bacteria must be introduced into the body. This occurs either from direct contact with someone carrying the bacteria, or because of the bacteria being carried by the person him or herself.

Group A Strep is the same bacteria that causes strep throat. However, there are various strains of the bacteria, some of which are more powerful than others (with stronger m-protein serotypes). If the right set of conditions are present, this is when the necrotizing fasciitis occurs.

The "right" set of conditions are:

A person usually has to have a contusion, abrasion, cut, or opening in the skin in order to have the bacteria enter, however, spontaneous cases where no apparent injury can be found, are also reported.

They have to come into contact with the bacteria, either through direct contact with a carrier, or because the bacteria is present on the person.

It usually is an invasive strain or serotype, of the strep.

There are higher risk groups for contracting NF, however, a person does not need any predisposing conditions to be prone to developing necrotizing fasciitis. It can happen to anyone...young, old, adult, child, any race, any size, healthy or not. No one is out of danger. You do not need to be immunodepressed to get this.

The name "flesh-eating-bacteria" is a little sensational, but essentially, this is what the bacteria appears to do. It gets into the body, quickly reproduces, and gives off toxins and enzymes that destroy the soft tissue and fascia, which quickly becomes gangrenous (dead). This gangrenous tissue must be surgically removed to save the life of the patient. The bacteria also stealthily hides itself from the body's innate immune system, allowing it to spread rapidly along tissue planes. NF causes excruciating pain, dangerously low blood pressure, confusion, high fever, and severe dehydration due to the toxins poisoning the body. Unfortunately, NF sometimes occurs beneath the skin with few symptoms to explain the victim's symptoms. This results in a great many cases of misdiagnosis.

If NF is detected during the early stages (before toxic shock), the need to surgically remove skin and soft tissue can be "relatively" small, with removal of flesh and subcutaneous tissue, and fat only. The bacteria usually does not attack muscle or bone (although it can happen). In more advanced cases (and this is often) major limb amputation is necessary.

Death from this condition is not uncommon, however many people are successfully treated.

In addition to the tissue decay, the bacteria causes the rest of the body's organs to go into systemic shock. This may result in respiratory failure, heart failure, low blood pressure and renal failure. Basically, every system of the body can fail as a result of the severe infection and toxicity of the system.

NF is not a reoccurring condition. Once treated, the bacteria is eradicated from the body. During treatment, surgical sites are left open for a sufficient period of time and reinspected to be sure that the remaining tissue is no longer being destroyed. When physicians are confident that the infection has been stopped, the wounds are closed, typically with skin grafting. Then the recovery process starts which involves lengthy physical therapy, and long-term psychological, emotional and spiritual recovery. NF is truly a devastating disease.

When the infection is caused by the lightening fast Group A Strep bacteria, the specific bacteria which causes the flesh-eating disease, people can go from perfectly healthy to death's door in a matter of days. Other cases of NF, caused by a mixed bag of bacteria, can be slower moving and less deadly. In all cases, however, prompt treatment is essential in this condition. It is one of the fastest spreading infections known, so time is the most important factor in survival.


Flesh eating bacteria - Necrotizing fasciitis

SYMPTOMS: http://www.nnff.org/nnff_symptoms.htm

Unfortunately necrotizing fasciitis often has flu-like symptoms, so initially, the natural assumption is for the individual to believe they have the flu. Often, NF occurs in otherwise healthy, active individuals. No major trauma is necessary. In fact, the condition often occurs following minor trauma, or even a bruise or abrasion. As mentioned above, it can occur after surgery.

Perhaps the most troubling and frightening aspect of NF is its remarkable ability mimic minor afflictions -- which fools both the patient and the doctor. Misdiagnosis is very common, which, in light of the speed and deadliness of the infection, often has severe consequences, such as multiple limb amputation and too often, death. In post-surgical patients, NF often mimics common post-operative symptoms such as severe pain, inflammation, fever and nausea, which also thwarts a timely diagnosis.

Education and awareness by the general public as well as the medical community in recognizing symptoms is critical to saving lives. The following depicts general symptoms of NF as the disease advances:
Trauma of some type (however slight) will probably have occurred (cut, bruise, scratch, surgery).

Victim begins to feel an annoying discomfort in the general region of the trauma (in the case of NNFF co-founder Donna, she felt the type of pain one feels after working out a little too hard in her upper arm, the day after getting a small cut on her finger).

The pain described gets worse, the area more tender. This is one of the major things to keep in mind. The pain one feels is out of proportion to the injury.

Flu-like symptoms occur, such as vomiting, diarrhea, dehydration, general malaise, weakness, muscle pain, and fever.

Tissue is swollen and there may or may not be redness noted. The area will feel hot to the touch, and very painful.

Conditions continue to worsen.

Urination becomes less frequent (as the system dehydrates)

Blood pressure drops severely, and heartbeat is rapid.

A sunburn type rash may appear over the entire body, due to toxins released from the bacteria. This may or may not be present.

Large, dark boil-like blister(s) may or may not form in the affected area

Toxic shock can ensue as the body's organs shut down.

It is important that the patient report all symptoms to his or her physician to ensure a swift and accurate diagnosis!

Preventive Measures

First, let it be said that there is no sure prevention. Necrotizing fasciitis has been known to be spontaneous. A bruise or abrasion are all the "opening" in the skin necessary for bacteria to enter. However, there are some things you can do decrease risk.

The single biggest preventative measure is keeping the skin intact!

Next is cleanliness. Always wash even the smallest opening in the skin and apply an antibiotic ointment. Buy tubes of antibiotic ointment and keep one in your car, your desk, your exercise bag, and at home.

Take care with your children, impressing upon them the importance of cleanliness.

Be respectful to protect others from infection if you suspect that you may have a Strep infection, such as Strep throat, or have been exposed to someone with a known Strep infection. Symptoms do not have to be present for a person to be carrying the bacteria and infect others. One case of infection that comes to mind is a health care worker with two children at home with Strep throat. She had no symptoms, but innocently infected three people, one of whom died.

These simple measures are the most protection one can give oneself against any infection.

It just can't be stressed enough, however, that a pin prick (one woman became infected at the point of entry from a blood draw) can be the opening it takes.

National Necrotizing Fasciitis Foundation (NNFF)



Comments from Sadly Anonymous

Excellent Post, Tina!!

Let me set the scene:
On 11/29/2000, I had a freak auto accident. As I got out of an Idling Vehicle, it slipped into reverse and started rolling backwards, the open door knocked me to the ground, and I was dragged 30 feet on the ground before someone was able to stop the vehicle. The back of my left leg was severely lacerated. I had stage 3 LE in that leg. Emergency Dr, who SAID he knew how to treat LE, put in over 60 stitches & 23 staples, and sent me home, same day!, with instructions to "put neosporine on it", and some pain pills. Told to go see my family practice Dr in 2-3 days for follow up. Which I did, only regular Dr, who does know LE, was away for 2 week vacation.
I told his partner what he needed to know about LE and wounds, and he promptly told me to go home and "put neosporine on it"
On 12/14/2000, the leg literally BURST with necrotizing fasciitis, and I lost over half of the back of my leg from it, before the Drs could stop it. I had several surgeries, & then debriedments daily by wound care specialists for over 18 days in hospital. Finally, went home with open wound, which required debriedment daily for over 8 1/2 months. Then I had debriedments for 2 more months in gradually desending amounts. The open wound never was able to be closed, nor was any skin grafting done, because the Drs felt the LE wouldn't allow it to heal, if it were closed. The toxins would keep the area from healing.
It took 15 months for the wound to close, although it still weeps from that area daily, so I have a hard time thinking it's ever really gonna be "healed"!
I have the most ugly, DEEP scars you can imagine, and the LE is basically stage 4 in that leg, or what's left of it. Like Pat, very little surface feeling, but deep-internal ache-like the worst toothache you can imagine.

Go immediately to the ER, & push with all you have in you to get the right treatment.


SORRY, I feel this very strongly. Infections like this go bad so quickly when you have LE, you just can't wait, even if you don't think you can afford to go in-GO!!!!!!

Lots more info/things I could tell about this, but I think you get the point that I'm serious about it. Thank you again, Tina, IT'S THE MOST IMPORTANT POST you've ever done, and you've done some GREAT ONES!!

sadly/sadly patty


From Pat

Flesh Eating Bacteria

This is so excellent!! Special Thanks to Tina for posting it and to Patty for her reply!


Necrotizing fasciitis

Synonyms and related keywords:

Fournier's gangrene, Fournier gangrene, Meleney's ulcer, Meleney ulcer, postoperative progressive bacterial synergistic gangrene, flesh-eating bacteria, Cullen's ulcer, Cullen ulcer, hemolytic streptococcal gangrene, acute dermal gangrene, hospital gangrene, suppurative fascitis, synergistic necrotizing cellulitis, group A hemolytic streptococci, Staphylococcus aureus, Bacteroides fragilis, Escherichia coli, nonclostridial myonecrosis, Vibrio vulnificus, diabetes mellitus, fascial necrosis

Author: Michael Maynor, MD, Clinical Assistant Professor, Department of Hyperbaric/Emergency Medicine, Louisiana State University School of Medicine

Michael Maynor, MD, is a member of the following medical societies: Society for Academic Emergency Medicine, and Undersea and Hyperbaric Medical Society



Emergency Department Care:

Aggressively treat the patient with suspected necrotizing fasciitis to reduce morbidity and mortality.

Perform endotracheal intubation in patients who are unable to maintain their airway.

Provide supplemental oxygen.

Obtain IV access. Be careful to not use an infected extremity.
Place patient on continuous cardiac monitoring.
Begin fluid resuscitation with normal saline or lactated Ringer solution.

In patients with suspected hypovolemia, Foley catheterization may be needed to monitor urine output. This procedure should probably be avoided in patients with Fournier gangrene.
Begin antibiotics as soon as possible.


Obtain early surgical consultation for aggressive debridement.

Consider surgical subspecialty consultation for necrotizing
fasciitis involving specific anatomic areas, as needed.

Obtain urological consultation in cases of Fournier gangrene.
Consult with a hyperbaric specialist.

A consultation with an infectious disease specialist may be useful to guide initial empiric antibiotic therapy.

http://www.emedicine.com/EMERG/topic332 ... ~treatment


Necrotizing soft tissue infection

Alternative names

Necrotizing fasciitis; Fasciitis - necrotizing; Flesh-eating bacteria; Soft tissue gangrene; Gangrene - soft-tissue


Necrotizing soft-tissue infection is a severe type of tissue infection that can involve the skin, subcutaneous fat, the muscle sheath (fascia), and the muscle. It causes gangrenous changes, tissue death, systemic disease, and frequently death.
Causes, incidence, and risk factors Return to top

Necrotizing subcutaneous infection or fasciitis can be caused by a variety of bacteria including oxygen-using bacteria (aerobic) or oxygen-avoiding bacteria (anaerobic). A very severe and usually fatal fasciitis is caused by a virulent species of streptococcus that is often referred to as the "flesh-eating bacteria" by the press.

This type of infection develops when bacteria enter the body, usually through a minor skin injury or abrasion. The bacteria begin to grow and release toxins that:

Directly kill tissue
Interfere with the blood flow to the tissue
Digest materials in the tissue which then allows the bacteria to spread rapidly
Cause widespread effects, such as shock
Infection may begin as a small reddish painful spot or bump on the skin. This quickly changes to a painful bronzed or purplish patch that expands rapidly. The center may become black and dead (necrotic). The skin may break open. Visible expansion of the infection may occur in less than an hour.

Symptoms may include fever, sweating, chills, nausea, dizziness, profound weakness, and finally shock. Without treatment death can occur rapidly.


Severe pain in the area
Swelling in the area
Discoloration in the area
May appear reddened, bronzed, bruised, or purple (purpuric)
Progresses to dusky, dark color
Bleeding into the skin
Visibly dead (necrotic) tissue
Patchy skin color
Skin breaks (open wound)
Skin around the wound feels hot and looks reddened, raised, or discolored (inflamed)
Oozing fluid ranging from yellowish clear or yellowish bloody to puslike in quality
General ill feeling

Signs and tests

The appearance of the skin and underlying tissues and presence of gangrenous changes (black or dead tissue) indicates a necrotizing soft tissue infection. Imaging tests, such as CT scans, are sometimes helpful.

Often a patient will need to go to the operating room so a surgeon can diagnose such an infection. A Gram stain and culture of drainage or tissue from the area may reveal the bacteria to blame.


Powerful, broad-spectrum antibiotics must be administered immediately. They are given in a vein to attain high blood levels of the antibiotic in an attempt to control the infection. Surgery is required to open and drain infected areas and remove dead tissue.

Skin grafts may be required after the infection is cleared. If the infection is in a limb and cannot be contained or controlled, amputation of the limb may be considered. Sometimes pooled immunoglobulins (antibodies) are given by vein to help fight the infection.

If the organism is determined to be an oxygen-avoiding bacteria (anaerobe) the patient may be placed in a hyperbaric oxygen chamber, a device in which the patient is exposed to 100% oxygen at several atmospheres of pressure.

Expectations (prognosis)

Outcomes are variable. The type of infecting organism, rate of spread, susceptibility to antibiotics, and how early the condition was diagnosed all contribute to the final outcome.

Scarring and deformity are common with this type of disease. Fatalities are high even with aggressive treatment and powerful antibiotics. Untreated, the infection invariably spreads and causes death.


local spread of infection, progressive tissue damage
systemic spread of infection, sepsis, shock
scarring and disfigurement
functional loss of a limb

Calling your health care provider

This disorder is severe and may be life-threatening, so consult your health care provider immediately.

Call your health care provider if signs of infection occur around a skin injury: pain, swelling, redness, drainage of pus or blood, fever, or other similar symptoms.


Clean any skin injury thoroughly. Watch for signs of infection such as redness, pain, drainage, swelling around the wound, and consult the health care provider promptly if these occur.

Update Date: 1/16/2004

http://www.nlm.nih.gov/medlineplus/ency ... 001443.htm



Necrotizing Fasciitis/Myositis
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Necrotizing Fasciitis/Myositis
("flesh-eating disease")



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