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What is Necrotizing Fasciitis and What Happens If It Goes Untreated?

Necrotizing fasciitis (NECK-re-tie-zing FASH-e-i-tis) is a fatal bacterial infection that spreads quickly. The term “necrotizing” refers to something that causes the death of another. The term “fasciitis” refers to inflammation of the fascia, which is the subcutaneous (under the skin) tissue that surrounds muscles and nerves and holds everything in place, including fat and blood vessels. Necrotizing fasciitis, also known as “Flesh-Eating Disease,” causes gangrenous changes, tissue death, and systemic disease, and frequently results in the patient’s death. Every year, between 600 and 700 cases are diagnosed in the United States. About 25% to 30% of those cases result in death. Necrotizing fasciitis kills about one in every three people.

If necrotizing fasciitis is detected and treated early, the chances of survival without more severe consequences are significantly higher than if the necrotizing fasciitis is not detected and treated until it has progressed to a more advanced stage. Any unnecessary delay in diagnosing or treating necrotizing fasciitis can have tragic consequences. Unfortunately, warning signs are often ignored, and treatment is delayed. The most common forms of negligence or medical malpractice by physicians in diagnosing and/or treating patients with necrotizing fasciitis include failing to test for necrotizing fasciitis when a patient reports warning signs or symptoms that can be caused by necrotizing fasciitis, delaying necrotizing fasciitis diagnosis, failing to order appropriate treatment for a patient with necrotizing fasciitis, and failing to follow up with the patient. A doctor may violate his or her professional duty of care by performing an incorrect differential diagnosis. A healthcare provider creates a list of potential diagnoses and then tests each one to rule out all but the correct diagnosis. Doctors can also violate the professional standard of care by misreading test results, failing to treat necrotizing fasciitis with antibiotics quickly, or administering an incorrect antibiotic or dose. If you or someone you care about has suffered from serious complications of necrotizing fasciitis as a result of a physician’s or another health care provider’s negligence, you should contact an attorney right away to see if you can file a medical malpractice or, in some cases, wrongful death lawsuit. Contact DeFrancisco & Falgiatano for a free case evaluation. We serve clients throughout Upstate New York, with offices in several convenient locations. Our extensive experience in the field of medical malpractice is reflected in the results we have obtained for our clients.

A common misconception about necrotizing fasciitis is that the condition is caused by only ONE type of bacteria. Several types of bacteria can cause the condition, the most common of which is Group A Streptococcus, the same bacteria that causes strep throat. While Group A strep bacteria are the most common cause of necrotizing fasciitis, it can also be caused by bacteria found in water. Other bacteria that cause necrotizing fasciitis include Escherichia coli (“E Coli”), Clostridium, Aeromonas hydrophila, Pseudomonas, Prevotella, Klebsiella, Vibrio vulnificus, and Staphylococcus aureus. This type of deep tissue infection can overwhelm the immune system, resulting in sepsis and/or sepsis shock. Sepsis is a complication caused by an infection. When we have sepsis, our bodies release chemicals into our bloodstream to fight infection. However, the sudden injection of chemicals can cause inflammation, which can lead to other dangerous conditions and symptoms such as multiple organ failure, fever, difficulty breathing, mental confusion, low blood pressure, and even death.

The bacteria that cause necrotizing fasciitis can enter the body through surgical wounds, puncture wounds, burns, minor cuts, insect bites, or abrasions. It can also enter if you have an injury that does not break the skin at all. In some cases, the cause of the infection is unknown. However, once established, the infection rapidly destroys muscle, skin, and fat tissue.

A weakened immune system and certain diseases may increase your chances of getting necrotizing fasciitis. Alcoholism, cancer, having had chicken pox as a child, cirrhosis, diabetes, heart disease affecting the heart valves, chronic kidney disease, lung disease, including tuberculosis, peripheral vascular disease, steroid use, and use of injectable or IV drugs are all risk factors. Necrotizing fasciitis is most commonly found on limbs, fingers, and toes. Necrotizing fasciitis is more common in the lower extremities (toes, feet, etc.), especially if you have diabetes.

The first sign of necrotizing fasciitis may be a reddish, painful swollen spot or bump on the skin. The affected area will turn into a painful bronzed or purplish patch that will rapidly expand. The skin may rupture. Blisters filled with blackish fluid may form in the infected area. The area could turn purple, black, and dead. The infection may spread. Systemic symptoms may include disproportionate pain, fever, sweating, chills, nausea, dizziness, thirst, and profound weakness. However, within a few days, symptoms worsen and, if not treated promptly, can result in death or permanent loss of limbs or organs. As the infection spreads, the patient’s blood pressure drops, causing toxic shock and unconsciousness. Without treatment, death can occur quickly.

Early diagnosis and treatment are critical in cases of necrotizing fasciitis. Following the onset of symptoms, a doctor can review the patient’s medical history, perform a physical exam to look for signs of infection, and suggest specific diagnostic tests. The presence of several of the above-mentioned warning signs and symptoms, as well as gangrenous and necrotic changes (black or dead tissue) around the infection site, should raise the possibility of necrotizing fasciitis. Imaging tests, such as CT scans, can be beneficial at times. A Gram stain and culture of the area’s drainage or tissue may reveal the bacteria responsible. If your doctor suspects you have necrotizing fasciitis, they may order the following tests:

  • Blood tests like a complete blood count.
  • Deep tissue culture specimens.
  • Biopsy of tissue.
  • Imaging tests, including a computed tomography (CT) scan.

To control necrotizing fasciitis, prompt intervention is required, which will most likely necessitate exploratory surgery to confirm the diagnosis. Surgery is used to open and drain infected areas as well as to remove dead tissue (debride). Multiple surgeries may be required to control the infection and remove all of the dead tissue. It usually takes three surgeries to completely remove the infection. The first step in treating necrotizing fasciitis is to administer strong, broad-spectrum IV antibiotics right away. Antibiotics are usually given to achieve a high enough blood level of the antibiotic to control the infection. Medications to raise blood pressure, as well as blood and anti-globulins, may need to be administered concurrently. If the infecting organism is an oxygen-avoiding bacteria, a hyperbaric oxygen chamber can be used to expose the bacteria to 100% oxygen at varying pressures. If an infection in a limb cannot be contained or controlled, the limb may need to be amputated. Skin grafts or plastic surgery may be required following surgery to help the wounds close completely.

Many factors influence a patient’s prognosis after contracting necrotizing fasciitis, including the type of infecting organism, the rate of spread, and antibiotic susceptibility. Furthermore, the severity of necrotizing fasciitis complications increases the longer the infection goes untreated. Scarring, limb loss (arms, legs, fingers, toes), toxic shock syndrome, sepsis, and death are possible complications.

You can recover compensatory damages if you can prove liability. The nature and amount of damages are determined by the severity of the injury. Some patients, for example, require life-saving surgery and must remain in intensive care before proceeding to a lengthy, costly rehabilitation program. You may be able to recoup your lost income, medical expenses, rehabilitation costs, loss of enjoyment, and pain and suffering caused by necrotizing fasciitis.

If you or someone you love has suffered from serious complications of necrotizing fasciitis due to the neglect of a physician or other healthcare provider, our law firm may be able to help you recover damages from responsible parties. Our expert medical malpractice attorneys at DeFrancisco & Falgiatano represent injured patients throughout Upstate New York, including Syracuse, Rochester, Albany, Binghamton, Auburn, Elmira, Norwich, Cortland, Delhi, Herkimer, Watertown, Lowville, Oneida, Wampsville, Utica, Canandaigua, Oswego, Cooperstown, Ithaca, Lyons, and all of Upstate New York. Call us at 833-200-2000 or contact us via our online form.

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