Causes and risk factors
The bacteria commonly responsible for this condition are Streptococcus, Vibrio vulnificus, and Aeromonas hydrophila. They usually enter the skin through a cut or a wound. The flesh eating bacteria enter the skin, invade underlying tissues, set in reaction of inflammation and infection. The release of toxins and enzymes by these bacteria cause vascular damage, ischemia, and result in necrosis of the tissue. Certain chemicals like cytokines release and can cause generalized state of toxicity, sepsis, shock, multiorgan invasion, and failure and death in severe cases. High rate of morbidity and mortality is associated. The following are the risk factors for this infection: Diabetes mellitus, obesity, alcoholism, injectable substance abuse, immunocompromised status, peripheral vascular disease, liver cirrhosis, and cancer.
Clinical presentation
It is of 3 types depending upon the type and number of organism, area and death of tissue involved. It can present as cellulitis, fasciitis, or myositis depending upon death of involved skin and underlying tissue. In the initial phase, patient presents with skin eruptions which are tiny, red, and painful. These may later progress to a very painful bruise-like area within hours. The center may become black and die [necrosis]. Oozing of fluid from the affected region is seen. Associated symptoms include fever with chills, weakness, dizziness, and nausea. Person may end up in shock.
Investigations
Medical history by the patient and clinical examination by the doctor helps in diagnosis. X-rays, ultrasounds, CT scan, MRI scan of the affected part is recommended. Biopsy of the soft tissue is obtained.
Treatment
Intravenous antibiotics are required immediately. Radical debridement of the affected tissues is done. Fluid and electrolyte balance is monitored and maintained. Hyperbaric oxygen therapy to improve wound healing is helpful. IV immunoglobulins [a type of antibodies] may be administered.
Complications
Complications such as gangrene, shock, multiorgan failure, sepsis, scarring of skin, disability if a limb is amputated may occur.
When to Contact a Doctor
This condition is a medical emergency. You must contact a doctor as soon as you see any sign of a soft tissue infection.
Prevention
Every cut, injury, etc., must be thoroughly cleaned with antiseptic for precautions and cared for.
Systems involved
Integumentary system, circulatory system
Organs involved
Skin, blood vessels
