Symptoms and Signs of Necrotizing Fasciitis
(Flesh-Eating Disease)

Medical Author: John P. Cunha, DO, FACOEP
Medically Reviewed on 3/11/2019

Doctor's Notes on Necrotizing Fasciitis
(Flesh-Eating Disease)

Necrotizing fasciitis (NF), also called flesh-eating disease (bacteria), is a rapidly progressive infection that primarily affects the connective tissue planes (fascia) just under the skin, where it can spread rapidly and involve adjacent soft tissue, leading to widespread tissue death (necrosis). It is a rare condition, but can be life-threatening.

Early on, there may be few symptoms of necrotizing fasciitis (flesh-eating disease) other than pain or soreness, similar to that of a "pulled muscle." As the infection rapidly spreads, the symptoms necrotizing fasciitis include an area of localized redness, warmth, swelling, and pain, often resembling a superficial skin infection (cellulitis). The pain and tenderness is often out of proportion to the visible findings on the skin. Other symptoms of necrotizing fasciitis include fever, chills, feeling unwell (malaise), nausea, vomiting, weakness, dizziness, and confusion. Within hours to days, the skin redness rapidly spreads and skin may become dusky, purplish, or dark in color. Blisters, black scabs, hardening of the skin, skin breakdown, and wound drainage may develop. A fine crackling sensation due to gas within the tissues may sometimes be felt under the skin (crepitus). Nerve damage progresses and localized numbness of the affected area may occur. If untreated, the infection spreads throughout the body, often leading to sepsis (infection in the bloodstream) and often death.

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Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.