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Necrotizing soft tissue infection - Treatment

Alternative Names

Necrotizing fasciitis; Fasciitis - necrotizing; Flesh-eating bacteria; Soft tissue gangrene; Gangrene - soft tissue

Treatment:

Powerful, broad-spectrum antibiotics must be given immediately through a vein (IV). Surgery is required to open and drain infected areas and remove dead tissue. Sometimes donor immunoglobulins (antibodies) are given by vein to help fight the infection.

Skin grafts may be needed after the infection goes away. If an arm or leg infection cannot be controlled, amputation of the limb may be considered.

If the bacteria is determined to be an oxygen-avoiding organism (anaerobe), the patient may receive hyperbaric oxygen therapy. This involves placing the patient in a chamber that delivers 100% oxygen at high pressure.

Expectations (prognosis):

How well a patient does depends on:

  • How fast the diagnosis was obtained
  • The type of bacteria causing the infection
  • How quickly the infection spreads
  • How well the antibiotics work

Scarring and deformity are common with this type of disease. The death rate is high, even with aggressive treatment and powerful antibiotics. Untreated, the infection spreads and causes death.

Complications:

  • Local spread of infection, progressive tissue damage
  • Systemic spread of infection, sepsis, shock
  • Scarring and disfigurement
  • Functional loss of an arm or leg
  • Death

Calling your health care provider:

This disorder is severe and may be life threatening, so contact your health care provider immediately if symptoms of infection occur around a skin injury, including:

  • Drainage of pus or blood
  • Fever
  • Pain
  • Redness
  • Swelling
  • Reviewed last on: 12/17/2009
  • Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine; Daniel Levy, MD, Infectious Disease, Maryland Family Care, Lutherville, MD. Review provided by VeriMed Healthcare Network.Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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