# data[].attributes.attachment_link.provider_name
Centers for Disease Control and Prevention

# data[].attributes.attachment_link.readable_text
Error processing SSI file

Necrotizing fasciitis (NECK-re-tie-zing FASH-e-i-tis) is a rare bacterial infection that spreads quickly in the body and can cause death.

Accurate diagnosis, rapid antibiotic treatment, and prompt surgery are important to stopping this infection.

See a doctor right away if your skin becomes red, warm, swollen, or very painful soon after an injury or surgery.

Group A strep thought to be most common cause

There are many types of bacteria that can cause the "flesh-eating disease" called necrotizing fasciitis. Public health experts believe group A Streptococcus (group A strep) are the most common cause of necrotizing fasciitis. This web page only focuses on necrotizing fasciitis caused by group A strep bacteria.

Bacteria that live in water, including Vibrio vulnificus, can also cause necrotizing fasciitis. Learn about Vibrio wound infections.

How you get necrotizing fasciitis

The bacteria most commonly enter the body through a break in the skin. Different breaks in the skin can include:

Cuts and scrapes

Burns

Insect bites

Puncture wounds (including those due to intravenous [IV] drug use)

Surgical wounds

However, people can also get necrotizing fasciitis after blunt trauma (an injury that does not break the skin).

Necrotizing fasciitis is rarely contagious

Most cases of necrotizing fasciitis occur randomly. It is very rare for someone with necrotizing fasciitis to spread the infection to other people. For this reason, doctors usually do not give preventive antibiotics to close contacts of someone with necrotizing fasciitis.

Necrotizing means causing the death of tissues. Fasciitis means inflammation of the fascia (the tissue under the skin that surrounds muscles, nerves, fat, and blood vessels).

Symptoms can often be confusing and develop quickly

The infection often spreads very quickly.

Early symptoms of necrotizing fasciitis can include:

A red, warm, or swollen area of skin that spreads quickly

Severe pain, including pain beyond the area of the skin that is red, warm, or swollen

Fever

See a doctor right away if you have these symptoms after an injury or surgery. Even though minor illnesses can cause symptoms like these, people should not delay getting medical care.

Later symptoms of necrotizing fasciitis can include:

Ulcers, blisters, or black spots on the skin

Changes in the color of the skin

Pus or oozing from the infected area

Dizziness

Fatigue (tiredness)

Diarrhea or nausea

Some people are at increased risk

While anyone can get necrotizing fasciitis, it is rare.

Other health factors

Most people who get this illness have other health problems that may lower their body's ability to fight infections. Some conditions that weaken the body's immune system include:

Diabetes

Kidney disease

Cirrhosis (scarring) of the liver

Cancer

Diagnosis can be difficult and acting fast is key

There are many infections that look similar to necrotizing fasciitis in the early stages, which can make diagnosis difficult. In addition to looking at the injury or infection, doctors can diagnose necrotizing fasciitis by:

Performing a biopsy (taking a tissue sample)

Looking at bloodwork for signs of infection and muscle damage

Looking at imaging (CT scan, MRI, ultrasound) of the damaged area

However, it is important to start treatment as soon as possible. Therefore, doctors may not wait for test results if they think a patient might have necrotizing fasciitis.

Prompt treatment is key

Necrotizing fasciitis is a very serious illness that requires care in a hospital. Antibiotics and surgery are typically the first lines of defense if a doctor suspects a patient has necrotizing fasciitis.

Doctors treat necrotizing fasciitis with IV antibiotics.

Antibiotics

To try to stop the infection, doctors give antibiotics through an IV, which allows medicine to flow into a vein.

Sometimes, however, antibiotics cannot reach all the infected areas because the bacteria have killed too much tissue and reduced blood flow. When this happens, doctors must surgically remove the dead tissue.

Surgery

Since necrotizing fasciitis can spread so rapidly, patients often must get surgery done very quickly. It is not unusual for someone with necrotizing fasciitis to end up needing multiple surgeries. In serious cases, the patient may need a blood transfusion.

Up to 1 in 5 people with necrotizing fasciitis die from the infection.

Serious complications are common

Necrotizing fasciitis can lead to

It can also result in life-long complications from loss of limbs or severe scarring due to surgically removing infected tissue.

Looking at data from the most recent five years:

Even with treatment, up to 1 in 5 people with necrotizing fasciitis died from the infection

Up to 1 in 3 people who got both necrotizing fasciitis and streptococcal toxic shock syndrome at the same time died from their infections

Prevent necrotizing fasciitis

There are no vaccines to prevent group A strep infections, but there are things you can do to help protect yourself and others.

To help prevent group A step infections, you should:

Wash your hands often

Clean and care for wounds

Clean and care for wounds

If you have an open wound or skin infection, avoid spending time in:

Hot tubs

Swimming pools

Natural bodies of water (e.g., lakes, rivers, oceans)

Care for fungal infections like athlete's foot to help prevent group A strep infections. Learn about athlete's foot (ringworm).

CDC tracks necrotizing fasciitis caused by group A strep bacteria

CDC tracks necrotizing fasciitis caused by group A strep bacteria with a special system called Active Bacterial Core surveillance (ABCs). Since 2010, approximately 700 to 1,150 cases occur each year in the United States. This is likely an underestimate. According to ABCs data, the number of annual group A strep necrotizing fasciitis infections reported to ABCs does not appear to be rising.

Related diseases

# data[].attributes.attachment_link.description
Necrotizing fasciitis is a rare bacterial infection that spreads quickly and can cause death. Accurate diagnosis, rapid antibiotic treatment, and prompt surgery are important to stopping it.

# data[].attributes.body
Necrotizing Fasciitis is a rare disease among humans that is typically caused by Group A Streptococcus. Although there are many other flesh eating bacteria that can cause Necrotizing Fasciitis such as, Klebsiella, Clostridium, and E.coli, the main culprit would be group A Streptococcus (“Necrotizing Fasciitis”) .The bacteria Streptococcus can enter the body through a cut and in some cases after blunt trauma. This causes the tissues to die and swells up the tissues around our muscles.

# data[].attributes.body
Group A Streptococcus

# data[].attributes.body
Some symptoms appear rather earlier than later. Some symptoms that appear earlier include:

Red or swollen skin that spreads easily

Fever

Some symptoms that appear later are:

Oozing and pus from affected area

Ulcers, blisters, and black spots on affected area or tissue that died (“Necrotizing Fasciitis: All You Need to Know”)

# data[].attributes.attachment_caption
This diagram shows the mortality rates of people that have Necrotizing Fasciitis 

# data[].attributes.body
Mortality Risk in Necrotizing Fasciitis about how certain disorders or problems

that people have prior to getting necrotizing Fasciitis effects

their mortality rate. For example, people with diabetes, liver disease, older

age, acute renal failure, and not undergoing surgery to remove the dead effected

tissues, results in having a lower chance of surviving Necrotizing Fasciitis.

# data[].attributes.body
Infographic made by "Necrotizing Fasciitis Foundation"

# data[].attributes.attachment_link.readable_text
Fellow in advanced head and neck surgical oncology and microvascular reconstruction
Otolaryngology-Head & Neck Surgery

Specialties

Head and neck benign and malignant lesions

Thyroid and parathyroid tumors

Sinonasal benign and malignant tumors

Reconstruction of head and neck defects

Education

Medical Degree: Baghdad University College of Medicine, 2008

MPH: Tulane University School of Public Health and Tropical Medicine, 2013

Residency: University of Iowa Hospitals and Clinics, 2023

Locations

Dr. Al-Qurayshi sees patients at:

Leadership Roles & Honors

International liaison of the American Head and Neck Society - Endocrine Section

National Institutes of Health (NIH) - Institutional National Research Award (T32), 2017-2018

Iraq Scholars and Leaders Program (ISLP), 2011-2013

Member of Delta Omega Honorary Society in Public Health

Select publications

1. Al-Qurayshi Z, Bennion DM, Greenlee JDW, Graham SM. Endoscopic pituitary surgery: A national database review. Head Neck. 2022.

2. Al-Qurayshi Z, Ngouajio AL, Buchakjian MR. Presentation and outcomes of patients with clinically T1-2, N0 supraglottic squamous cell carcinoma: The role of definitive radiotherapy compared to primary partial laryngectomy. Head Neck. 2022;44(3):735-744.

3. Al-Qurayshi Z, Peterson JD, Shama MA, Kandil E. Thyroidectomy practice in pediatric population: A national perspective. Am J Otolaryngol. 2022;43(2):103298.

4. Al-Qurayshi Z, Rossi-Meyer M, Shama MA, Williams AM, Bayon R, Kandil E. Presentation and outcomes of otolaryngologic surgeries in patients with mental illness history. Ann Otol Rhinol Laryngol. 2022:34894221105975.

5. Al-Qurayshi Z, Sullivan CB, Allison DB, Buchakjian MR. Presentation and outcomes of patients with clinically T1-2, N0 parotid mucoepidermoid carcinoma: The roles of elective neck dissection and adjuvant radiotherapy. Head Neck. 2022;44(10):2151-2161.

6. Al-Qurayshi Z, Zhu VL, Bayon R, Buchakjian MR. Presentation and outcomes of patients with clinically T1-2, N0 oropharynx squamous cell carcinoma: The interplay of primary treatment modality and human papillomavirus status. Head Neck. 2022.

7. Brooks JA, Abdelhamid Ahmed AH, Al-Qurayshi Z, et al. Recurrent laryngeal nerve invasion by thyroid cancer: Laryngeal function and survival outcomes. Laryngoscope. 2022;132(11):2285-2292.

8. Pham TA, Simmons B, Potter NJ, Al-Qurayshi Z, Carter KD, Graham SM. Revision orbital decompression for thyroid eye disease. Am J Otolaryngol. 2022;43(1):103196.

9. Seaman AT, Seligman KL, Nguyen KK, Al-Qurayshi Z, Kendell ND, Pagedar NA. Characterizing head and neck cancer survivors' discontinuation of survivorship care. Cancer. 2022;128(1):192-202.

10. Al-Qurayshi Z, Liu A, Walsh JE. Presentation and outcomes of non-squamous cell carcinoma sinonasal malignancies: A national perspective. Ann Otol Rhinol Laryngol. 2021:34894211024783.

11. Al-Qurayshi Z, Randolph GW, Kandil E. Cost-effectiveness of computed tomography nodal scan in patients with papillary thyroid carcinoma. Oral Oncol. 2021;118:105326.

12. Al-Qurayshi Z, Sullivan CB, Khadra H, Shama M, Lee GS, Kandil E. Presentation and outcomes of patients with undifferentiated thyroid carcinoma: A national perspective. Gland Surg. 2021;10(6):1971-1979.

13. Al-Qurayshi Z, Sullivan CB, Pagedar N, Lee GS, Tufano R, Kandil E. Prevalence and risk of metastatic thyroid cancers and management outcomes: A national perspective. Laryngoscope. 2021;131(1):237-244.

14. Al-Qurayshi Z, Wafa EI, Hoffman H, Chang K, Salem AK. Tissue-engineering the larynx: Effect of decellularization on human laryngeal framework and the cricoarytenoid joint. J Biomed Mater Res B Appl Biomater. 2021;109(12):2030-2040.

15. Al-Qurayshi Z, Wafa EI, Rossi Meyer MK, Owen S, Salem AK. Tissue engineering the pinna: Comparison and characterization of human decellularized auricular biological scaffolds. ACS Appl Bio Mater. 2021;4(9):7234-7242.

# data[].attributes.attachment_link.title
Zaid Al-Qurayshi, MBChB - Otolaryngology-Head & Neck Surgery

# data[].attributes.attachment_link.description
Zaid Al-Qurayshi, MBChB, is a fellow in Advanced Head and Neck Surgical Oncology at Washington University School of Medicine.

# data[].attributes.attachment_link.title
Flesh Eating Bacteria (Necrotizing fasciitis)

# data[].attributes.body
To prevent Necrotizing Fasciitis, make sure to properly wash and clean all wounds

Treatments such as surgery to remove the dead tissue will help prevent further spread

Usage of antibiotics will also help recovery after surgery

# data[].attributes.headline
Some Fun Facts provided by Texas A&M Health

# data[].attributes.subject
Some Fun Facts provided by Texas A&M Health

# data[].attributes.attachment_link.readable_text
Although not an everyday occurrence, the phrase "flesh-eating bacteria" seems to flash across the evening news every few weeks. Hector Chapa, MD, FACOG, clinical assistant professor of obstetrics and gynecology at Texas A&M College of Medicine, discusses this frightening phrase and what it means for our fun in the sun during these hot months.

What are flesh-eating bacteria?

In general, the phrase 'flesh-eating bacteria' refers to a tissue-destroying infection called necrotizing fasciitis. Since 2010, approximately 700 to 1,200 cases occur every year in the United States. Furthermore, roughly one in three people who contract it die from the infection.

"With a quick diagnosis, rapid treatment and fast surgery, flesh-eating bacteria does not have to be fatal," Chapa said. "The trick is to quickly identify it and seek immediate help."

What are the different kinds of flesh-eating bacteria?

Various types of bacteria can cause flesh-eating bacteria. However, the two most common causes are Group A streptococcus and vibrio. These bacteria can live in lakes, oceans, swimming pools and even hot tubs.

Group A streptococcus is a bacterium also known to cause strep throat, scarlet fever and rheumatic fever. While spreading this bacterium through strep throat is relatively common, spreading necrotizing fasciitis is rare.

"Vibrio, or vibrio vulnificus and vibrio alginolyticus, is the bacteria associated with the summertime seawater exposures of flesh-eating bacteria that are currently in the news," Chapa said. "You can contract vibrio from salt water or brackish water, but also from eating raw or undercooked shellfish."

Both types of bacteria can cause an infection to enter the system through breaks in a person's skin. This break in skin can be something as small as an insect bite or scrape, but also something as large as a surgical incision.

What are the symptoms of flesh-eating bacteria?

A flesh-eating bacteria infection can spread quickly. The first signs of an infection are an increasingly large presence of red or swollen skin. The red skin will be painful, and its appearance will be followed by a fever.

Symptoms of a more progressed flesh-eating bacterial infection are ulcers, blisters or black spots under the skin. Another symptom is the presence of pus oozing from the infected area. People affected also feel dizzy, fatigued and even nauseous.

"If you notice a combination of these symptoms, whether you have been in the ocean or not, then contact your health care provider immediately," Chapa said. "With flesh-eating bacteria, you want to get help as soon as possible."

Are certain people more susceptible to flesh-eating bacteria than others?

Overall, this infection is rare. However, it can happen and it is life threatening.

"People with impaired immune systems-like those with cancer, uncontrolled diabetes or any variety of autoimmune conditions-are more likely to contract flesh-eating bacteria," Chapa explained. "These high-risk people are also more likely to develop a more serious infection from it as well."

How do you treat flesh-eating bacteria?

"Antibiotics and surgery are the first line of defense if someone contracted necrotizing fasciitis," Chapa said. "However, if the infection has killed too much tissue, then a surgeon may need to surgically remove the dead tissue to prevent it from spreading."

In serious cases, you may need a blood transfusion and multiple surgeries to successfully get rid of necrotizing fasciitis.

How do I avoid contracting flesh-eating bacteria?

If you have an open wound, health care providers will recommend you avoid going in the water. "However, if you do go in water, it is very important to completely rinse off and wash yourself with soap," Chapa said. "Also, watch your skin for any unusual changes or sores, especially if you have a compromised immune system."

Lastly, before going to your local lake or beach, check the Centers for Disease Control and Prevention's website for health alerts.

# data[].attributes.attachment_link.title
Fast facts: Flesh-eating bacteria - Vital Record

# data[].attributes.attachment_link.description
With the recent discussions about flesh-eating bacteria, a clinical assistant professor at the Texas A&M College of Medicine explains what you need to know.