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What To Know About Necrotizing Cellulitis And Necrotizing Fasciitis
Necrotizing cellulitis and necrotizing fasciitis are bacterial soft tissue infections that enter through wounds in the skin.
Cellulitis is a common infection that occurs when bacteria enter the deeper layers of skin and the soft tissue beneath the skin. Without treatment, cellulitis may lead to necrosis, which is the death of bodily tissue in the skin.
Necrotizing fasciitis is a rare and severe bacterial infection that causes necrosis in the connective tissues of the muscles and other tissues and may lead to serious complications and death. It may develop as a complication of cellulitis.
Although necrotizing cellulitis and fasciitis share various similarities, the infections can require different methods of diagnosis.
This article looks at both conditions and their associated symptoms. It also looks at the causes, risk factors, diagnoses, treatments, and outlook for both types of infection.
Necrotizing cellulitis, which people also call gangrenous cellulitis, is a severe progression of the common skin infection called cellulitis.
Cellulitis typically occurs when bacteria enter the skin through wounds, such as cuts from injuries or insect bites or stings. The infection occurs in the deep layers of the skin and the surrounding tissue.
If a person receives an early diagnosis and treatment for cellulitis, they typically make a complete, fast recovery.
Without treatment, however, cellulitis may spread and progress. The infection may cause necrosis of the skin and the tissue underneath the skin. This involves the irreversible damage and death of cells in the skin and surrounding tissue. Necrosis may spread to the other soft tissues.
Learn more about cellulitis.
Necrotizing fasciitis is a rare bacterial infection that affects the soft tissues and the fascia, a thin lining of connective tissue that surrounds the muscles, blood vessels, and nerves.
Necrotizing means causing the death of cells in the tissue, and fascia refers to inflammation of the fascia.
The infection is severe and spreads rapidly through the body.
Learn more about necrotizing fasciitis.
Types of infectionThere are four main types of necrotizing fasciitis. Each type refers to the bacteria that causes the infection.
These types of necrotizing fasciitis are:
Fungal infections may also lead to necrotizing fasciitis in people with compromised immune systems.
Necrotizing cellulitis and necrotizing fasciitis may present similarly.
Symptoms of necrotizing cellulitisSymptoms that occur in the skin may include:
Erythema refers to changes in skin coloration. Depending on a person's skin tone, this can appear as red, pink, purple, or a subtle darkening of the existing skin color.
A person may also experience flu-like symptoms, such as:
Symptoms of necrotizing fasciitisNecrotizing fasciitis spreads rapidly. Symptoms that occur in the skin may include:
A person may also experience:
Bacteria entering the body through wounds in the skin cause necrotizing cellulitis and fasciitis. The risk factors for each type of infection and some of the bacteria that cause them differ.
Causes and risks for necrotizing cellulitisBacteria from the Staphylococcus and Streptococcus groups most commonly cause cellulitis. They may enter through a wound such as a cut or scrape, insect bite, burn, or surgical incision.
Without treatment, the infection may spread and can result in necrosis of the skin and surrounding soft tissue.
Risk factors include various health conditions, such as:
Other risk factors include:
Bacteria entering through wounds in the skin typically cause the infection. A person may also contract the bacteria from direct contact with someone who is carrying it.
The responsible bacteria can include:
Risk factors include various health conditions, such as:
Other risk factors include:
The methods of diagnosis for necrotizing cellulitis and fasciitis may differ. Diagnosis can include a physical exam and laboratory tests, such as blood tests.
Diagnosing necrotizing cellulitisDoctors often diagnose cellulitis by its appearance.
They may perform a physical examination and ask questions regarding a person's symptoms and medical history. They may also carefully examine a person's skin to help determine where the bacteria entered the body.
A doctor will not typically order blood tests or imaging to diagnose cellulitis.
Diagnosing necrotizing fasciitisTo diagnose necrotizing fasciitis, a doctor may carefully examine the site of infection and injury. They may also order laboratory tests, which can include:
The treatment for necrotizing necrotizing cellulitis and fasciitis can include antibiotics, hospitalization, and the surgical removal of necrotic tissue.
Treating necrotizing cellulitisTreatment for necrotizing cellulitis can involve:
Doctors typically begin treatment for necrotizing fasciitis immediately, as the infection spreads rapidly and often leads to severe complications.
Treatment can involve:
The outlook for necrotizing cellulitis and fasciitis may depend on how early a person receives diagnosis and treatment.
Outlook for necrotizing cellulitisThe outlook for cellulitis is typically positive. However, necrotizing cellulitis may require extensive treatment, including surgery.
If a person does not receive timely treatment, cellulitis can lead to severe complications. These include blood infection, bone tissue infection, sepsis, and necrotizing fascia.
Outlook for necrotizing fasciitisThe outlook for necrotizing fascia is generally poor. Complications of the infection are common and can include organ failure and sepsis.
According to the Centers for Disease Control and Prevention (CDC), even with treatment, 1 in 5 people with the infection died based on 5 years' worth of data.
Necrotizing cellulitis and fasciitis are bacterial infections that enter through openings in the skin and cause tissue death.
Necrotizing cellulitis affects the deep layers of skin and surrounding tissues, and fasciitis affects the fascia and other deep tissues.
Both infections are severe and can be life threatening. They may present with similar symptoms and require similar treatment. Treatment can include antibiotics and the surgical removal of necrotic tissue.
Hyperbaric Oxygen Therapy Reduces Mortality In Necrotizing Soft Tissue Infections: Study
Necrotizing soft tissue infections are life-threatening conditions that require immediate medical attention usually leading to high mortality rates and significant morbidity among survivors. A recent analysis unveiled promising outcomes for the application of Hyperbaric Oxygen Therapy (HBO) in treating Necrotizing Soft Tissue Infections (NSTI) which is a severe bacterial infection that...
Necrotizing soft tissue infections are life-threatening conditions that require immediate medical attention usually leading to high mortality rates and significant morbidity among survivors. A recent analysis unveiled promising outcomes for the application of Hyperbaric Oxygen Therapy (HBO) in treating Necrotizing Soft Tissue Infections (NSTI) which is a severe bacterial infection that destroys tissues under the skin. The key findings of this study were published in the World Journal of Emergency Surgery.
The conventional treatment approach includes aggressive surgical debridement, antibiotics and supportive care. The potential of HBO therapy, which involves breathing pure oxygen in a pressurized room or chamber, has been a subject of medical interest for enhancing recovery and outcomes in NSTI patients. The comprehensive meta-analysis drew data from PubMed, Embase, Web of Science and the Cochrane Library to ascertain the effectiveness of HBO when compared to standard treatments.
The study meticulously examined several observational trials which encompassed the data from a total of 49,152 patients, including 1,448 who underwent HBO therapy and 47,704 who received conventional care. The findings showed a significant reduction in the mortality rates among the patients treated with HBO, with a relative risk (RR) of 0.522 by indicating a 47.8% decrease in death rates when compared to those who did not receive HBO.
While the HBO group required a increased number of debridements to remove dead tissue, there was no significant difference in amputation rates that dispel concerns about the therapy leading to increased limb loss. The incidence of multiple organ dysfunction syndrome (MODS), a lethal complication of NSTI, was markedly lower in the HBO-treated group that suggests a substantial benefit in preventing critical complications.
These encouraging outcomes caution the evidence which primarily derived from retrospective studies that necessitates further validation through prospective research. The availability of HBO therapy which is not universally accessible across all healthcare facilities also poses a limitation to its widespread adoption. The study underscore the importance of individual patient assessment and timely surgical intervention to optimize treatment outcomes. Overall, the outcomes from this comprehensive analysis suggests a potential shift in the management of NSTI by advocating for the integration of HBO therapy as a complementary treatment strategy.
Reference:
Huang, C., Zhong, Y., Yue, C., He, B., Li, Y., & Li, J. (2023). The effect of hyperbaric oxygen therapy on the clinical outcomes of necrotizing soft tissue infections: a systematic review and meta-analysis. In World Journal of Emergency Surgery (Vol. 18, Issue 1). Springer Science and Business Media LLC. Https://doi.Org/10.1186/s13017-023-00490-y
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