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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.
NNFF
would like to thank Dr. Steven Triesenberg, MD (Infectious Disease
Specialist) in Grand Rapids, Michigan
for his assistance in compiling this information. |
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