The Katherine Jacobs Trust

Necrotising Fasciitis (NF) is a rare bacterial soft tissue infection which advances very quickly and causes widespread necrosis (death) of fasciae*. The bacteria most closely linked to NF are the group A beta-haemolytic streptococci although many patients have mixed infections involving multiple species of bacteria or fungi. The condition was first described in 1884 but it was not until 1952 that the infection was named Necrotising Fasciitis by Wilson.

Group A Streptococci are common bacteria which can be carried on the skin and also found in the throat and nose. They are often involved in sore throats and they do not generally cause serious infections. NF can occur when the immunity of the patient is low and predisposing factors include age (over 60) malnutrition, skin wounds, diabetes, alcohol and drug abuse, cancer, obesity, steroid treatment, renal failure and vascular disease. NF can also occur after operations. However, NF can occur in young, previously healthy individuals.

Patients in the early stages of  NF tend to present with symptoms of fever and chills and develop excessive pain with only minor skin changes. If left untreated, the patient deteriorates very quickly and the skin over the infected area turns purple and  forms blisters. As the infection spreads into the underlying tissues, the patient often develops toxic shock leading to the failure of vital organs. If this stage is reached, the patient is unlikely to recover.

For the patient to survive it is crucial that the condition is recognised quickly so that high doses of appropriate antibiotics can be administered. At the same time, the dead and dying tissue must be surgically removed and amputation is often required. Even if the infection is treated quickly, the death rate is still high and survivors may need extensive skin grafting and plastic surgery.

*Fasciae are sheets or bands of fibrous connective tissue enveloping, separating or binding together muscles, organs and other soft tissues of the body.