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Necrotizing Fasciitis is a bacterial skin infection which quickly destroys skin tissue and muscle, along with subcutaneous tissue. Commonly known as “flesh-eating disease”, it is primarily caused by more than one bacterium that begins the decay of the fascia (soft tissue that is part of the connective tissue system that is spread throughout our bodies). This disease is very rare and fatal, as there have been 600 – 700 cases diagnosed in the US every year; about 25% to 30% of these cases result in death. Found by a Confederate Army surgeon between 1840 to 1870, there has been an increase in those in African or Asian countries; however, there are not enough documents to prove this statement. The disease is typically not transmitted from person to person, but most cases occur randomly. People are more likely to get an infection when there is any type of lesion in the skin, even bug bites. Those who are diagnosed with diabetes, kidney disease, cancer, or any other health condition that affects the immune system are also a higher risk of becoming infected with Necrotizing Fasciitis. Considering there are three types of Necrotizing Fasciitis, Type 1 often occurs after any type of trauma or any type of surgery. Type 2 occurs when there are very small, and seemingly insignificant skin scratches (cuts, insect bites, etc.). Type 3 occurs after the wound has been contaminated with dirt that contains the Clostridium bacteria. The Clostridium bacteria can produce gas in tissues (known as gangrene) and necrotic eschars (piece of dead tissue on the skin). Around the world, men are affected more than women (roughly 3:1). The symptoms are commonly mistaken for other illnesses; these symptoms typically consist of fever, chills, fatigue, and vomiting. After the first 24 hours of infection, there have been multiple reports of redness, pain, sensitivity and swelling in the infected areas. Following those initial symptoms, about 3-4 days after the first sign of symptoms, one might experience swelling (with a purple rash), violet colored marks that become blisters filled with a foul-smelling liquid, discoloration, peeling, and flakiness. This is often when gangrene occurs. Gangrene is the deterioration of the epidermal (skin) layers. At this point, it is strongly advised that the affected patient be seen by a doctor. However, if one chooses not to, 4-5 days after the infection begins, one might experience a severe drop in blood pressure, toxic shock, and possibly unconsciousness.Caused by a single bacterium or multiple bacteria, (Group A Streptococcus, Klebsiella, Clostridium, Escherichia coli, Staphylococcus aureus, and Aeromonas hydrophila), the pathogen will infect the subcutaneous tissue (the tissue underneath the skin) by entering the body through an external injury (cuts, etc.) or through a punctured internal organ. Then, the bacteria spread through the fascia and release endo-toxins and exo-toxins. Endo-toxins are toxins that cause the bacteria to die and break apart, while exo-toxins are the waste of the bacteria. This action of lysis and toxic waste product released in the skin restricts blood supply to the tissue and digestion of cells by enzyme. This results in an excess of pus and fluids remaining in the dead tissue and even an impact on any major organ system; this can lead to an illness that affects the entire body.Those who are infected with flesh-eating bacteria will typically undergo more than one treatment plan; since this disease tends to spread very quickly, one strong antibiotic is not sufficient. Treatments include IV antibiotic therapy, surgery (removing damaged and dead tissue to stop the spread of infection; possible amputation), medication to elevate blood pressure, hyperbaric oxygen therapy (preserve healthy tissue), cardiac monitoring, blood transfusions, and intravenous immunoglobulin (supports the body’s ability to fight infections) One might be able to lower their risk of getting an infection. One can reduce their risk by following basic hygienic practices, such as frequently washing your hands with soap and properly treating any type of wound, even if the wound itself looks insignificant. If one already has a wound, it is ideal to take the best care of it. In other words, regularly change your bandages (after a prolonged time of use and when they become wet and dirty). It is also ideal that one avoid going into places where the risk of contracting the bacteria through the wound. According to the CDC, it also advised that those who have a wound of any type stay out of places like whirlpools, hot tubs, and swimming pools since bacterial growth in those places are very high.The outcome of Necrotizing Fasciitis strictly depends on how severe the condition is. It is significantly better when the patient gets an early diagnosis; the earlier the diagnosis, the earlier one can be treated. For those who don’t undergo surgery have a mortality rate of 100%. For those who have recovered from the deadly infection can range from a minor scarring to a limb amputation; as this shows that every case and every outcome is different for every person. But taking precautionary steps will minimize the risk of contracting the deadly flesh-eating bacteria. Sources”CDC Features.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 3 July 2017, www.cdc.gov/Features/NecrotizingFasciitis/.PhD, Charles Patrick Davis MD. “Necrotizing Fasciitis: Flesh-Eating Disease Causes & Symptoms.” MedicineNet, www.medicinenet.com/necrotizing_fasciitis/article.htm.”Necrotizing Fasciitis: Causes, Symptoms, & Treatment.” Healthline, Healthline Media, www.healthline.com/health/necrotizing-soft-tissue-infection#outlook. “Necrotizing Fasciitis (Flesh-Eating Bacteria).” WebMD, WebMD, www.webmd.com/skin-problems-and-treatments/necrotizing-fasciitis-flesh-eating-bacteria#1.Schulz, Steven A. “Necrotizing Fasciitis.” Background, Pathophysiology, Etiology, 21 Nov. 2017, emedicine.medscape.com/article/2051157-overview.”Necrotizing Fasciitis.” NORD (National Organization for Rare Disorders), rarediseases.org/rare-diseases/necrotizing-fasciitis/.

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