1.+What+is+Necrotizing+Fasciitis?


 * Necrotizing Fasciitis : Bacteria gone bad **

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 * Necrotizing fasciitis, also known as "flesh eating bacteria", is most commonly transferred by respiratory droplets or direct contact with secretions of someone carrying strep A (Streptococcus pyogenes). This bacteria attacks the soft tissue and the fascia (sheath of tissue covering muscle)(1). The name flesh-eating bacteria sounds a bit extreme but basically this is what the bacteria does. When the bacteria enters the body it quickly multiplies. Toxins and enzymes are produced that break down the soft tissue and fascia, rapidly killing the tissue. Gangrenous tissue must be removed in order to save the life of a patient. The bacteria is capable of hiding itself from the bodies immune system, which allows it to spread quickly. **

=**Most necrotizing soft tissue infections have anaerobic bacteria present, usually in combination with aerobic gram-negative organisms. Facultative aerobic organisms grow since polymorphonuclear (PMN) leukocytes exhibit decreased function under hypoxic wound conditions. This growth further lowers the oxidation/reduction potential, enabling more anaerobic proliferation and, thus, accelerating the disease process. **=

=**In necrotizing fasciitis, approximately 10% of cases are due to aerobes, 20% due to anaerobes, and 70% of cases due to mixed flora(3). **= = = =**The first known case of necrotizing fasciitis goes back to Hippocrates’ description of an erysipelas complication in the 5th century B.C. "...the erysipelas would quickly spread widely in all directions. Flesh, sinews and bones fell away in large quantities...Fever was sometimes present and sometimes absent...There were many deaths. The course of the disease was the same to whatever part of the body it spread."(3) The first case in the United States was discovered in 1871 by a Civil War surgeon who described cases of hospital gangrene. The term necrotizing fasciitis was first used in 1952 and describes the most consistent feature of the infection, fascial necrosis(3). **=