Necrotizing fasciitis is a serious but rare infection of the deeper layers of skin and subcutaneous tissues (fascia). While many other types of bacteria can cause necrotizing fasciitis, most cases result from Group A streptococcus.

The infection occasionally starts with pharyngitis (sore throat), but more often begins locally, at a site of trauma, which may be severe (such as the result of surgery), minor, or even non-apparent. The affected skin is very painful, red, hot and swollen. Skin color may progress to violet and blisters may form, with subsequent necrosis (death) of subcutaneous tissues. Patients with necrotizing fasciitis typically have a fever and appear very ill. More severe cases progress within hours, and the death rate is high. The diagnosis is confirmed by either blood cultures or aspiration of pus from tissue. Early medical treatment is critical. Treatment often includes intravenous penicillin and clindamycin. If necrotizing fasciitis is suspected, surgical exploration is always necessary, often resulting in aggressive debridement (removal of infected tissue). Limb amputation may be necessary.

This disease is one of the fastest-spreading infections known, and tissue may be consumed at a rate of 3 cm per hour. For this reason, it is popularly called the flesh-eating disease and, although rare, became well-known to the public in the 1990s. Even under world best-care practices today, the prognosis is a mortality rate of around 20 percent. Mortality is nearly 100 percent if not properly treated. Correct diagnosis and early treatment of this disease is therefore of extreme importance.

Recently (April 2005), a rarer but even more serious form of the disease has been observed to be increasing in frequency, with several cases having been found especially in California. In these cases, the bacterium causing it was a strain of staphylococcus aureus (i.e. staphylococcus, not streptococcus as stated above) which is resistant against methicillin, the antibiotic one would usually use. (See Methicillin-resistant Staphylococcus aureus for details.)

This disease was also featured in the modern horror classic Cabin Fever.

Well-known victims

• Lucien Bouchard, former Quebec premier, who became infected while leader of the federal official opposition Bloc Québécois party. He lost a leg to the illness.
• Eric Allin Cornell, winner of the 2001 Nobel Prize in Physics, who lost his left arm and shoulder to the disease in 2004.
• Melvin Franklin, bass singer for The Temptations. Though Franklin's condition was diagnosed early enough to prevent complete amputation of his arm, he died from other health complications soon afterward in 1995.

External links

• Hoax: Bananas imported from Costa Rica causes Necrotizing Fasciitis (refutation or information available from: CDC and FDA, CDC, Snopes.com, CIAC HoaxBusters)
• National Necrotizing Fasciitis Foundation official website