Sunday, April 5, 2009

NECROTIZING FASCIITIS


Necrotizing fasciitis is a relatively rare bacterial infection of the inner layers of skin and subcutaneous tissues. The disease is characterized by the rapid spread of bacteria along the fascial plane causing significant tissue damage. There are 2 types of Necrotizing Fasciitis, one is caused by multiple microbes (Type 1) and the other is caused by a single microbe (Type 2.) Since 2001 the leading monomicrobial cause of the disease has been MRSA. Prior to that, the most common culprit was Strep A.

The infection begins at a site of trauma. The trauma can be major such as a surgical cut or as minor as a paper cut. Once the bacteria is introduced to the wound, it rapidly multiplies and makes its way throughout the underlying tissues. The first symptoms of NF include pain at the trauma site (often more intense than the wound warrants) followed by swelling around the point of introduction. As the bacteria multiplies and releases toxins, the patient will begin to experience fever and vomiting. If the wound is shallow there will be apparent swelling, but if the would is deep the infection can progress to fever before outward signs of the infection appear at the site of the wound. The toxins from the bacteria actually kill the tissue that they come into contact with, causing it to begin to rot.

Mortality rates from SF are around 73%. Treatment includes antibiotics, but if the bacteria is unresponsive to treatment, surgery might be required to preserve unaffected tissue from the spread of the bacteria (amputation.)

Since this sick is so painful and spreads so rapidly through the body causing significant mortality levels, I rate it a

5 on my "lethality scale" (1-10)
and a 6 on my "disturbing scale" (1-10)

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