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Necrotising Fasciitis
How Do You Get Necrotising Fasciitis?

How Do You Get Necrotising Fasciitis?

Necrotising fasciitis is a rare but severe infection of the soft tissues. It is widely known as the 'flesh-eating disease' because it looks as though the tissue is being eaten, although that is not actually the case.

But how do you get necrotising fasciitis in the first place?

A bacterial infection

The first thing to note is that necrotising fasciitis is a bacterial infection. There are many different types of bacteria and only some of these will lead to necrotising fasciitis.

Typically necrotising fasciitis is caused by the Streptococcus bacteria, which is also responsible for causing a sore or 'strep' throat. Necrotising fasciitis can also occur as a result of Clostridium, E.coli, Staphylococcus aureus and Klebsiella, to name but a few. Sometimes a combination of bacteria will lead to the infection.

However, you will not get necrotising fasciitis just because the skin comes into contact with these bacteria. Indeed, the Streptococcus bacteria frequently cause a throat infection, but a sore throat does not mean you will get necrotising fasciitis.

The only way in which necrotising fasciitis can happen is if the bacteria get into the deep tissues. The bacteria must therefore enter through a break in the skin, which acts as a protective layer, and travel down through the tissues.

How do the bacteria get inside the body?

So how do the bacteria penetrate the skin and reach the deep tissues? Typically there will be some kind of break in the skin. Bacteria are so small they cannot be seen, so it does not take a very large break in the skin for them to get through.

Some examples of the ways in which bacteria can get into the body and cause necrotising fasciitis are described below:

Surgical wound

There is always a risk of infection with surgery because it involves cutting the skin, which normally acts as a barrier to prevent bacteria getting in. Those undergoing open surgery are more at risk, but even keyhole surgery can lead to a post-surgical infection. The bacteria may be living on the skin or surrounding surfaces and will enter the body through the surgical incision.

Cut, graze or other injury

Bacteria can also enter through smaller, much less obvious injuries. Anything that breaks the skin presents bacteria with an opportunity to get inside the body. This includes nicks, cuts, grazes, paper cuts and other such injuries. The cut may be so small that you do not even know it is there.


Although it is slightly different to a cut or wound, a burn is also vulnerable to infection. At the very least the top layer of skin will be burned away, leaving the deeper layers of skin (and potentially tissue) exposed. Additionally, the skin may blister and these can burst, giving the bacteria an opening through which to enter.

Needle puncture wound

Needles used for a blood test, injection or cannula will puncture the skin. While this hole will be very small, it is sufficient for bacteria to get into the body.


A urinary catheter drains urine from the bladder into a bag. A thin tube is fed into the bladder through the urethra or the abdomen. Bacteria can enter the bladder during the insertion of the catheter, or bacteria may travel along the catheter at a later stage.

Insect bites

Insect bites are another way in which the skin can be punctured. This might be a spider bite, flea bite or other insect bite. Bacteria can enter through the bite wound, which will have pierced the skin.


In some cases of necrotising fasciitis the reason for infection is unknown. The patient may not recall any sort of traumatic injury that caused a break in the skin, and no injury can be seen.

Factors that increase the risk of necrotising fasciitis

Necrotising fasciitis can affect anyone of any age, although it is very rare in children. Generally people who are young and healthy are more resistant to infections such as necrotising fasciitis. But that is not to say that it cannot happen.

There are some factors that will increase the risk of necrotising fasciitis occurring. These include:

  • Immuno-suppression
  • Advanced age
  • Peripheral vascular disease
  • Obesity
  • Intravenous drug use
  • Diabetes

Most of these risk factors relate to poor circulation, which is a feature of old age, peripheral vascular disease, diabetes and obesity. This increases the risk because the tissues are deficient in oxygen and so are already unhealthy. This will make it difficult to fight infections inside the tissue. People whose immune systems are compromised will also have trouble trying to contain an infection.

What to do if you get necrotising fasciitis

If you get necrotising fasciitis, you need to get emergency medical attention. You need to be admitted to hospital and given broad-spectrum antibiotics intravenously. You also need urgent debridement surgery to remove all the dead and infected tissue.

Necrotising fasciitis is characterised by symptoms such as:

  • Fever
  • Skin that is red, swollen and hot to touch
  • Severe pain in the tissue that is disproportionate to any injuries
  • Skin changes, with blisters and dark red/purple/black skin

If you are displaying these symptoms, it is likely you have some form of tissue infection, even if it is not necrotising fasciitis. For a diagnosis and treatment, you need to go to a medical setting. Blood tests, surgical exploration and lab cultures can determine whether you have necrotising fasciitis. If so, there should be no delay in performing surgery.

Delayed treatment of necrotising fasciitis

Necrotising fasciitis can be fatal if not treated urgently enough. The bacteria can spread beyond the tissues and into the bloodstream, triggering a condition called sepsis.

If you or your loved one has come to harm because necrotising fasciitis was not diagnosed and treated quickly enough, please get in touch with us at Glynns Solicitors. There could be grounds for a medical negligence claim, which would entitle you to pursue legal action against those at fault. If your claim is successful, you will be awarded compensation to reflect the damages incurred.

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