Necrotising fasciitis is a severe infection that rapidly leads to extensive necrosis of the skin, subcutaneous tissue and fascial compartments, as well as symptoms of toxic shock. According to research, 20-30 percent. cases, it is not possible to stop the development of the disease, which results in the death of the patient. What are the causes and symptoms of necrotizing fasciitis? How is this disease treated?

Necrotising fasciitisis an acute infection of the skin, subcutaneous connective tissue and fascial compartments - a membrane whose task is the outer cover of individual muscles, muscle groups and the entire layer (these include e.g. articular capsules of tendons and ligaments). The infection quickly leads to inflammation of the skin, subcutaneous tissue and fascia, and further to vasculitis and thrombosis, and consequently to tissue ischemia and necrosis.

Necrotising fasciitis - types and causes

Necrotising fasciitis can occur anywhere on the skin as a result of superficial skin infections, infections in the mouth caused by poor hygiene, open injuries, including stab wounds (e.g. piercing your ears yourself with home remedies) and surgical wounds.

  • Necrotising fasciitis - type I

It is a polymicrobial inflammation dominated by aerobic and anaerobic bacteria. Infection is often the result of trauma or invasive processes (e.g. surgery).

  • Necrotising fasciitis - type II

This type of disease is caused by the beta-hemolytic streptococcus ( Streptococcus pyogenes ) belonging to group A. Type II is called streptococcal hemolytic gangrene or "meat-eating disease".

  • Necrotising fasciitis - type III

It is caused by a rod of gas gangrene ( Clostridium perfringens ) and is therefore called gas gangrene.

Necrotising fasciitis - risk factors

People with cardiovascular diseases, diabetes and immunosuppressed (weakened immune systems), e.g. as a result of HIV infection, are at risk. Factors that trigger infection are also cancer, drugs (anti-cancer and anti-inflammatory). Alcoholism and drug addiction also findon this list.

Necrotising fasciitis - symptoms

The first symptoms of necrotizing fasciitis are:

  • swelling
  • slight blush
  • soreness

It comes very quickly (within a few hours):

  • application of the skin
  • bubble formation
  • necrotic skin scabs that resemble second and third degree burns
  • progressive loss of sensation in affected areas

In addition, there are general symptoms such as high fever, tachycardia (heart rate higher than 100 beats per minute), hypotension (a state of decreased muscle tone), disturbed consciousness.

Later, symptoms of disseminated intravascular coagulation and multi-organ failure can be observed, which leads to death if left untreated.

Important

MZP toxic shock syndrome

Necrotising fasciitis usually results in toxic shock syndrome, i.e. intoxication of the body caused by bacterial toxins. Its main symptoms are:

  • high fever
  • diffuse macular dermatitis (erythrodemia)
  • drop in blood pressure
  • diarrhea
  • vomiting
  • muscle aches
  • exfoliating the epidermis
  • headaches

Necrotising fasciitis - diagnosis

Diagnosis is made on the basis of symptoms, blood test results (often leukocytosis, low sodium concentration) and bacteriological examination.

Necrotising fasciitis - treatment

The first stage of treatment is the excision of dead tissue, which is often associated with amputation. Wounds are not closed, but left open until disease progression is stopped. During this time, the patient is in isolation, and the doctor rinses and cleans the wounds every day. When the spread of necro-inflammatory lesions is limited, they can be closed. In addition, the so-called empirical antibiotic therapy, i.e. the patient is given a combination of 2-3 antibiotics. Therapy with hyperbaric oxygen is also helpful.

Category:

Infectious diseases