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Medical Author:

Steven Doerr, MD

Steven Doerr, MD

Steven Doerr, MD, is a U.S. board-certified Emergency Medicine Physician. Dr. Doerr received his undergraduate degree in Spanish from the University of Colorado at Boulder. He graduated with his Medical Degree from the University Of Colorado Health Sciences Center in Denver, Colorado in 1998 and completed his residency training in Emergency Medicine from Denver Health Medical Center in Denver, Colorado in 2002, where he also served as Chief Resident.

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Medical Editor:

Charles Patrick Davis, MD, PhD

Charles Patrick Davis, MD, PhD

Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

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The symptoms and signs of necrotizing fasciitis vary with the extent and progression of the disease. Necrotizing fasciitis often affects the extremities or the genital area (Fournier's gangrene), though any area of the body may be involved.

Early in the course of the disease, patients with necrotizing fasciitis may initially appear deceptively well, and they may not demonstrate any superficial visible signs of an underlying infection. Some individuals may initially complain of pain or soreness, similar to that of a "pulled muscle." However as the infection rapidly spreads, the symptoms and signs of severe illness become apparent.

Necrotizing fasciitis generally appears as an area of localized redness, warmth, swelling, and pain, often resembling a superficial skin infection (cellulitis). Many times, the pain and tenderness experienced by patients is out of proportion to the visible findings on the skin. Fever and chills may be present. Over the course of hours to days, the redness of the skin rapidly spreads and the skin may become dusky, purplish, or dark in color. Overlying blisters, necrotic eschars (black scabs), hardening of the skin (induration), skin breakdown, and wound drainage may develop. Sometimes a fine crackling sensation may be felt under the skin (crepitus), signifying gas within the tissues. The severe pain and tenderness experienced may later diminish because of subsequent nerve damage, leading to localized anesthesia of the affected area. If left untreated, continued spread of the infection and widespread bodily involvement invariably occurs, frequently leading to sepsis (spread of the infection to the bloodstream) and often death.

Other associated symptoms seen with necrotizing fasciitis may include malaise, nausea, vomiting, weakness, dizziness, and confusion.

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