Polymicrobial Necrotizing Fasciitis is the result of two or more types of bacteria working together. Polymicrobrial NF makes up 59 to 69 percent of all cases. The most common bacteria involved in Polymicrobial NF were streptococci and enterobacteria strains. Streptococci are often found on the throat and on the skin and can cause mild illnesses such as strep throat or impetigo. Enterobacteria are part of the normal gut flora of mammals.
Flesh eating bacterial disease is medically known as Necrotizing Fasciitis (NF). While rare, the disease has garnered much press because of its aggressive nature, high mortality and grisly effects. The bacteria destroy soft tissue, interfere with blood flow and disrupt the immune system in as little as a few hours. Mortality rates can be as high as 76 percent with systemic organ failure and sepsis resulting from seemingly limited infection.
TYPE I: Polymicrobial
TYPE II: Monomicrobial
Streptococcus pyogenes is the most well-known single causative agent of NF and the most lethal. While it causes simple acute pharyngitis, S. pyogenes has the ability to completely disarm the immune system and strike those with no underlying vulnerabilities, making it potentially deadly. S. pyogenes is a beta-hemolytic bacteria whose toxin destroys the blood cells that kill foreign invaders and bacteria leaving its victims defenseless against the pathogen.
TYPE III: Marine Vibrios
Saltwater NF can occur when the Vibrio strain of bacteria enters a seemingly minor wound. Vibrio is a common marine bacteria that lives in saltwater and whose family is known to also cause cholera. Surfers and those who frequent oceans may sustain a small cut from a coral reef or ocean rock. The wound then serves as a portal of entry for infection. Chronic Liver Disease has been found to be a predisposing factor for acquisition.
Necrotizing Fasciitis is a surgical emergency. Early intervention is critical though diagnosis remains difficult because of the lack of differentiating signs. Once NF has been diagnosed a biopsy is performed to determine the causative bacteria. Immediate removal of the dead tissue (debridement) is crucial to survival and preservation of organs and limbs, though amputation may be necessary to prevent death. Broad spectrum antibiotic therapy accompanies debridement.
- MedlinePlus: Necrotizing Soft Tissue Infection
- American Family Physician; Necrotizing Soft Tissue Infections: A Primary Care Review; Adrienne J. Headley
- Journal of Bone and Joint Surgery; Chin-HoWong et. al; August 2003
- Photo Credit Hemera Technologies/PhotoObjects.net/Getty Images
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