Necrotizing fasciitis is a relatively rare condition that intravenous drug users are at risk of developing. Necrotizing fasciitis is often described in the media as the flesh eating bug, and this offers a fair description of what it involves. It is an extremely serious infection because one in four of the people who develop it will die as a result.
This condition involves a bacterial infection destroying body tissue. Necrotizing is a term used to describe tissue death while fasciitis refers to inflammation of the fascia. The fascia is a layer of fibrous tissue that can be found throughout the body. It usually starts in the deep layers of the skin and can rapidly spread to the destruction of fat, and tissue surrounding the muscle. It can be caused by different types of bacteria but is often associated with group A beta-hemolytic streptococci. In a lot of cases it will involve a combination of different kinds of bacteria.
The symptoms of necrotizing fasciitis tend to appear suddenly. There will usually have been some type of wound that made it possible for the bacteria to gain access to the body. The typical symptoms can include:
* Skin that looks inflamed – red, swollen, and warm to the touch
* Nausea and vomiting
* Flu like symptoms
* There may be pain at the site of an earlier injury
* Thirst due to dehydration
* Evidence of tissue death (late symptom)
* Dark marks on the skin (late symptom)
* Toxic shock symptoms which can include organ failure (late symptom)
* Loss of consciousness (late symptom)
Necrotizing fasciitis symptoms are often misdiagnosed because the condition is rare, and the symptoms are associated with many other causes.
Sometimes the cause of necrotizing fasciitis will not be obvious, but it is often related to the following:
* Any type of cut to the skin including from surgery
* Intravenous drug use
* Weak immune system
* Muscle strain even when there has been no damage to the skin
* Insect bites
* Wounds that come in contact with seawater
* IV drug use
* Viral infections that lead to a rash
* Occasionally it can be passed by close body contact with an infected person
IV drug users are at a higher risk of developing necrotizing fasciitis due to the fact that they regularly inject into their skin. This often leads to wounds and abscesses; particularly when black tar heroin is used. One study examined a population of drug users who developed the flesh eating bacteria and found that 55% of them had been intravenous users.
Not only can IV drug users be more at risk to developing necrotizing fasciitis, but it can also be easier for clinicians to miss. This is because such people will often have significant tissue damage due to their substance abuse. This is worrying because any delay in treating the problem can easily lead to death. Many IV drug users will already have a weakened immune system so this also puts them more at risk from this type of infection.
It is vital that necrotizing fasciitis receives prompt treatment as this will increase the chances of survival. Once diagnosed this condition is taken very seriously. The patient will often be kept in an intensive care unit – at least initially. The available treatments include:
* Surgery to remove any tissue that has been infected by the bacteria. The longer the condition has been allowed to progress the more tissue there will be to remove.
* It may be necessary to perform a limb amputation to stop the spread of the bacteria
* It might also be required that the surgeon removes body organs where the tissue has been infected
* Antibiotics will be given to help control the infection
* Hyperbaric Oxygen Therapy may be used in an attempt to prevent further tissue death
* Skin grafting to cover large wounds
* Other interventions may be necessary to support damaged organs and maintain vital signs
There are a number of actions that people can take if they want to reduce their risk of developing necrotizing fasciitis including:
* One of the most important things that people can do to avoid necrotizing fasciitis is to ensure that any wounds they have do not become infected. This means keeping them clean and protected from sources of infection.
* Good hand washing techniques can also reduce the risk of spreading this type of infection.
* Avoiding high risk activities such as intravenous drug use.
* If people have recently had a wound or muscle strain and start to experience unusual symptoms they should seek medical assistance.
* People should check their body regularly for any cuts or wounds they may have missed. This is particularly important for people who have any type of body numbness and therefore will not feel any pain from such an injury.
* Those who have been in close contact with somebody who has recently been diagnosed with necrotizing fasciitis should seek medical advice.
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