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Necrotising Fasciitis
Definition of Necrotising Fasciitis

Definition of Necrotising Fasciitis

Necrotising fasciitis is a bacterial soft-tissue infection. In this article we explain the definition of necrotising fasciitis in more detail.

Necrotising fasciitis definition

Necrotising fasciitis is a bacterial infection that affects the soft tissue and fascia (connective tissue). It is often described as being 'severe', 'aggressive' and 'acute'. In medical terms, an acute condition means that it develops very quickly.

Other names for necrotising fasciitis

Necrotising fasciitis is sometimes spelled necrotizing fasciitis. It has also been dubbed the 'flesh-eating disease' because it looks as though the tissue is being eaten away. This is not what is actually happening, as the bacteria are not consuming the flesh.

Necrotising fasciitis can affect any area of soft tissue in the body. When it occurs in the male genitalia, it can be called 'Fournier's Gangrene', after the scientist who first studied the condition.

Conditions like necrotising fasciitis

There are other, very similar conditions to necrotising fasciitis. For example, necrotising myositis is a bacterial infection of the muscles. Sometimes necrotising fasciitis can spread to the muscles, meaning the patient also has necrotising myositis.

Necrotising fasciitis is also very similar to cellulitis, an infection of the deeper layers of skin. The two have almost the same symptoms in the early stages, something which can confuse a diagnosis. Necrotising fasciitis can also be misdiagnosed as the flu.

Bacteria which cause necrotising fasciitis

Conditions such as necrotising fasciitis and cellulitis are often caused by the Group A Streptococcus (GAS) pathogen. There are other potential types of pathogen that can cause necrotising fasciitis, including Gram-negative monomicrobial infection and polymicrobial infections.

While necrotising fasciitis can be caused by various types of bacteria, it is important to note that necrotising fasciitis is a distinct pathological entity in which the tissues separate and necrose.

What does necrotising fasciitis do?

Necrotising fasciitis will make you feel very unwell, potentially with a fever. Most notably it will cause a localised area of tissue pain. This pain will be severe and inexplicable.

The site of this pain is the site of infection. It normally begins where there has been some form of skin trauma, such as a surgical incision, cut, burn or needle wound. This is because the bacteria has entered the body via the break in the skin. However, some will not be aware of any skin trauma, normally because the injury is so small and insignificant.

The area of pain will quickly expand due to the bacteria reproducing. The reproduction process releases a toxin, and this damages the surrounding tissue. Because of the tissue break down, blood cannot reach the area, leaving the tissue deficient in oxygen. Waste products which are normally carried away in the blood will also build up. As a result of all this, the tissue will ultimately break down and die. This is called tissue necrosis, thereby giving necrotising fasciitis its name.

What does necrotising fasciitis look like?

Necrotising fasciitis will cause the skin/tissue to change in appearance. At first the area of infection will be red, swollen and tender. These changes will become increasingly severe. The skin can turn to dark red to purple/black. Next, pus-filled blisters called 'bullae' can appear on the skin. Finally the tissue can begin to erode as necrosis takes place, which is why it looks as though the flesh is being eaten.

The appearance of necrotising fasciitis can therefore be extremely shocking. Sometimes the tissue will erode all the way down to the bone. Necrosis can also spread to organs, eyes and genitals. There are also times when a limb is so damaged by tissue necrosis that it must be amputated.

Can you die from necrotising fasciitis?

Yes you can die from necrotising fasciitis. In fact if no treatment is given the mortality rate is 100%. Generally a patient will not survive for more than 24 to 48 hours without any treatment.

The reason necrotising fasciitis can be fatal is that unless treatment is given, the bacteria will make their way to the bloodstream. This is called septicaemia and will set of a number of reactions which together are known as 'sepsis'.

Sepsis is very dangerous and kills around 37,000 people in the UK each year. It causes clotting and inflammation across the body, which means the blood does not flow normally. Consequently the heart is unable to pump blood properly, resulting in a drop in blood pressure. The organs become starved of oxygen and begin to fail.

Can you survive necrotising fasciitis?

Yes you can survive necrotising fasciitis, but only if treatment is provided in time. As mentioned above, this needs to be within 24 to 48 hours. Treatment must involve intravenous antibiotics and surgical debridement to remove the infected tissue. Absolutely all the infected tissue must be removed, so more than one operation may be required.

The earlier treatment is provided, the better. Not only will this give the patient a better chance of survival, it will also minimise the amount of tissue death. Necrotising fasciitis is a progressive disease that will start with a small area of tissue involvement, rapidly expanding to a large area of tissue.

Even if a patient does survive, the effects of widespread tissue death can entail a very long recovery. Some patients will suffer a long-term impact, physically and mentally. This is particularly true if there has been an amputation, or if there is extensive scarring/pain/dysfunction.

Necrotising fasciitis litigation

Necrotising fasciitis can be the source of a medical negligence claim. Because the condition must be diagnosed and treated so quickly, the consequences of any medical mistakes or delays will be very costly for the patient. When this happens, the patient or their family may be entitled to pursue legal action for the damages incurred, because they could have been avoided with earlier medical treatment.

A successful medical negligence claim will ensure the patient is awarded compensation for their pain and suffering, and for all the money they have lost as a result of their injuries. This can be substantial, especially if he/she is no longer able to work.

Want to know more?

If you would like any further information on necrotising fasciitis claims, please get in touch with us at Glynns Solicitors.

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