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Contents

Necrotizing Fasciitis


Images: Causative Organism, Symptoms, other relevant images


NF Agent.jpg

Toxins and tissue-degrading enzymes might have an important role in the severe diseases that are associated with GAS infection, including Necrotitis faciitis


NF2.jpg

These image shows that NF will affect muscular tissue as well as the skin.


NF3.jpg Strep. pyogenes.jpg S.pyogenes bloodagar.jpg

These are images of Streptococcus pyogenes aka flesh-eating bacteria.


S.pyogenes genome.jpg

This is the genome sequence of S. pyogenes

Background Information

Necrotizing means that of causing tissue death. Necrotizing faciitis (NF) is a rare disease caused by bacteria that kills the tissue it affects and the surrounding muscle and skin. The term NF did not occur until 1952. The bacteria that is involved in this rare infection is called Streptococcus pyogenes. NF is also referred to as 'flesh-eating bacteria'. S. pyogenes is a gram-positive, nonmotile, non-sporeforming coccus that will appear in chains or in pairs. They need a blood enriched media to grow. They have fermentative metabolism and are facultative anaerobes.

Streptococcus pyogenes is part of Group A Strep. This group includes the same bacteria that causes strep throat. In certain conditions such as:

1. A person would have to have a cut or some kind of opening in their skin so that the bacteria can have a point of entry.

2. A person would need to come into direct contact with someone carrying the disease or if the bacteria is already residing on the person.

3. When a person has an invasive strain of the strep.

necrotizing faciitis can occur.



Symptoms/Disease Cylce

The bacteria will enter the body through a minor cut and then grow and release harmful toxins that will directly kill the tissue, interfere with blood flow to the tissue, and break down materials in the tissue which then leads to the rapid spread of the bacteria and that can lead to shock.

General symptoms include: ill feelings, fever, sweating, chills, nausea, dizziness, extreme weakness, and shock. More specific symptoms include: small, redding painful spot or bump on the skin. The bump can quickly change into an excruciating painful bronze to purple color patch that continues to grow fast. THe center of the patch may turn black and die off. The skin may open and fluid may ooze out. The wound can quickly grow in less than and hour.

If not immediately treated, it could lead to death.


Statistics

Prognosis depends on how fast the diagnosis was obtained, the type of bacteria that caused the infection, how quickly the infection spreads, and how well the antibiotics work. There will most likely be scars and some disfigurement.

CDC reported in 1996 that there was an estimate of 500-1500 cases per year of NF and 20% of those die due to the complications of NF.

According to a journal article from The American Surgeon, there is a 25 to 60% mortality rate.


Treatment or Management of the Condition

Treatment includes antibiotics such as clindamycin and penicillin or IV antibiotics and it stops the toxins from being produced. More than one antibiotic may be used depending on other conditions.

In extreme cases, surgery is required. During surgery, infected tissue is removed and skin grafts are used to replace the skin and tissue that was removed or killed by the bacteria. In some cases, amputation is required. Both grafting and amputation lead to disfigurement and large scars.


These are images of recovering patients with NF:

Survivor1.JPG Survivor2.JPG Survivor3.JPG

Other relevant information

There isn't any true prevention methods but washing of wounds and cleaning wounds immediately are highly recommended. Also, if you are sick with strep throat keep exposure to others minimal and if you have exposed someone, please alert them that they have been exposed.


References

Miller MD, Aaron T., Payam Saadai MD, Alexander Greenstein MD, and Celia M. Divino MD. "Postprocedural Necrotizing Faciitis: A 10-Year Retrospective Review." The American Surgeon 74 (2008): 405-09. May 2008. Print. 1 Nov. 2010.

Batdorff, Donna, and Jackie Roemmele. Welcome to the National Necrotizing Fasciitis Foundation. 1997. Web. 1 Nov. 2010. <http://www.nnff.org/>.

"Necrotizing Soft Tissue Infection: MedlinePlus Medical Encyclopedia." National Library of Medicine - National Institutes of Health. 17 Dec. 2009. Web. 1 Nov. 2010. <http://www.nlm.nih.gov/medlineplus/ency/article/001443.htm>.

"Hardin MD : Necrotizing Fasciitis / Flesh Eating Bacteria." The University of Iowa Libraries. Web. 1 Nov. 2010. <http://www.lib.uiowa.edu/hardin/md/necrotizingfasciitis.html>.

Wong, Chin-Ho, and Yi-Shi Wang. "The Diagnosis of Necrotizing Faciitis." Skin and Soft Tissue Infections 18 (2005): 101-06. Print.


images:

http://nashfgpedaiah.blogspot.com/2010/06/streptococcus-pyogenes.html

http://microgen.ouhsc.edu/s_pyogenes/s_pyogenes_home.htm

http://www.nature.com/nrmicro/journal/v1/n3/fig_tab/nrmicro771_F1.html

http://www.effguide.com/2009/07/necrotizing-fasciitis-flesh-eating-disease-bacteria/

http://alsgals.wordpress.com/

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