Necrobiosis lipoidica diabeticorum - abdomen
Necrobiosis lipoidica diabeticorum - abdomen
Necrobiosis lipoidica diabeticorum - leg
Necrobiosis lipoidica diabeticorum - leg


Necrotizing soft tissue infection

Definition:
A severe type of tissue infection that can involve the skin, subcutaneousfat, the muscle sheath (fascia), and the muscle. It causes gangrenous changes, tissue death, systemic disease, and frequently death.

Alternative Names:
Necrotizing fasciitis; Fasciitis - necrotizing; Flesh-eating bacteria; Soft tissue gangrene

Causes, incidence, and risk factors:
Necrotizing subcutaneous infection or fasciitis can be caused by a variety of bacteria including oxygen-using bacteria (aerobic) or oxygen-avoiding bacteria (anaerobic). A very severe and usually fatal fasciitis is caused by a virulent specie of streptococcus that is often referred to as the "flesh-eating bacteria" by the press.

This type of infection develops when bacteria enter the body, usually through a minor skin injury or abrasion. The bacteria begin to grow and release toxins that:
  • Directly kill tissue
  • Interfere with the blood flow to the tissue
  • Digest materials in the tissue which then allows the bacteria to spread rapidly
  • Cause widespread systemic effects, such as shock

Infection may begin as a small reddish painful spot or bump on the skin. This quickly changes to a painful bronzed or purplish patch that expands rapidly. The center may become black and dead (necrotic). The skin may break open. Visible expansion of the infection may occur in less than an hour.

Systemic symptoms may include fever, sweating, chills, nausea, dizziness, profound weakness, and finally shock. Without treatment death can occur rapidly.




Review Date: 1/13/2002
Reviewed By: Camille Kotton, M.D., Infectious Diseases Division, Massachusetts General Hospital and Brigham and Women's Hospital, Boston, MA. Review provided by VeriMed Healthcare Network.

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