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What is Necrotizing Fasciitis by Jessica Chandler

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I choose to write about Necrotizing Fasciitis because of an article on CNN.com that I read last year about a college student, Aimee Copeland, who was zip-lining and injured herself.  The injury sent her to the hospital where she received 22 stitches to close up a gash she got on her calf.  She was sent home and 3 days later returned because of extreme pain and swelling.  I have followed her story since May 2012.  She is an inspiration and her story is amazing.  I have included a link in my references that will take the reader to her personal page that chronicles her complete journey.

Necrotizing (causing the death of tissue) Fasciitis is a rare but very deadly flesh-eating bacteria that spreads rapidly if not taken care of as soon as infection occurs.  If left untreated, will be a very painful struggle to survive.

Necrotizing Fasciitis can be caused by many different types of bacteria.  The main bacteria and most common is group A streptococcus.  This infection typically enters body through cuts, burns, insect bites, surgical sites, and even bruises.  As the bacterium grows it kills tissue and slowly disrupts blood flow to the infected area.  Once the tissue dies, the bacteria spreads rapidly affecting layers of membrane called fascia (connective bands of tissue).  Anyone can contract necrotizing fasciitis, but individuals with poor immune systems and/or other medical problems are typically at the highest risk.  NF (necrotizing fasciitis) is usually transferred by respiratory droplets or direct contact with the bacteria.

Symptoms of NF are usually brushed off by the unknowing victim and sometimes even overlooked by healthcare workers.  Within 24 hours, the victim will have a pretty good idea that something is terribly wrong.  Some early symptoms include but are not limited to:

  • Pain to the infected area similar to the feeling of a pulled muscle
  • Pain is typically in the same region as the abrasion, but not in the direct area (this is a huge indicator of the early signs of the bacteria infection)
  • Severe dehydration, due to flu-like symptoms such as diarrhea, vomiting, and weakness

These symptoms may seem minor but quickly and intensely escalate causing the infected area to swell, become very warm to the touch, and turn red or purple.  Once this happens, the area will fill with a blackish fluid that will most likely break open due to swelling and release the fluid.  After about 4-5 days, the infection will have reached the bloodstream causing extremely low blood pressure and will send the body into toxic shock.  When a case gets to this point, the patient will likely lose consciousness because the body will become too weak to fight the infection any longer.  Below are some images of necrotizing fasciitis, the first picture is on the inner thigh and the second picture is under the left breast of the victim/s.

The treatment of necrotizing fasciitis depends mainly on the severity of the infection and how long it has been present in the body.  No matter when found, the patient will immediately be given large doses of intravenous antibiotics.  One would hope that the hospitalization and antibiotics would be enough, but sadly, it is just the beginning if the infection has spread.  Since the bacterium slows the blood flow, the antibiotics typically do not reach all the areas of infection.  Because of this, surgery is usually needed to drain the sore and remove all the infected and dead tissue left behind by the bacteria.  Depending on how far the bacterium has spread, sometimes amputation could be imperative to stop the spread or just because there is nothing left to save.  Skin grafts are also usually performed to help the skin heal after the infection is removed.  Further treatment involves medications for higher blood pressure as well as intravenous immunoglobins, which are derived from donated blood and help the immune system to better fight infections.

The ultimate goal is to save everyone diagnosed with NF, but unfortunately, that does not happen.  Roughly 25 percent of patients die from either the disease or complications that occurred because of the bacteria infection (ex: septicemia).  Every year in the US, there are approximately 650-800 cases of necrotizing fasciitis.  That may seem like a low number and a slim chance of getting an infection, but considering the intensity and possible outcome of having the bacteria infection it’s worth it to get checked out if any symptoms present themselves!



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