Editing Necrotizing fasciitis (section)

{{short description|Infection that results in the death of the body's soft tissue}}
{{Infobox medical condition (new)
| name = Necrotizing fasciitis
| synonyms = Flesh-eating bacteria, flesh-eating bacteria syndrome,<ref>{{cite book|last1=Rakel|first1=David|last2=Rakel|first2=Robert E.|title=Textbook of Family Medicine|date=2015|publisher=Elsevier Health Sciences|isbn=9780323313087|page=193|url=https://books.google.com/books?id=8huMBgAAQBAJ&pg=PA193|language=en|url-status=live|archive-url=https://web.archive.org/web/20170908204612/https://books.google.com/books?id=8huMBgAAQBAJ&pg=PA193|archive-date=2017-09-08}}</ref> necrotizing soft tissue infection (NSTI),<ref name=Hak2014/> fasciitis necroticans
| image = Necrotizing fasciitis left leg.JPEG
| caption = Person with necrotizing fasciitis. The left leg shows extensive [[erythema|redness]] and [[necrosis|tissue death]].
| field = [[Infectious disease (medical specialty)|Infectious disease]]
| pronounce = {{IPAc-en|ˈ|n|ɛ|k|r|ə|ˌ|t|aɪ|z|ɪ|ŋ|_|ˌ|f|æ|ʃ|i|ˈ|aɪ|t|ɪ|s}} or {{IPAc-en|ˌ|f|æ|s|-}}
| symptoms = [[Pain out of proportion|Severe pain]], [[fever]], purple colored skin in the affected area<ref name=CDC2016/>
| complications = 
| onset = Sudden, spreads rapidly<ref name=CDC2016/>
| duration = 
| causes = Multiple types of [[bacteria]],<ref name=Paz2014/> occasional [[fungus]]<ref>{{cite book |last1=Ralston |first1=Stuart H. |last2=Penman |first2=Ian D. |last3=Strachan |first3=Mark W. J. |last4=Hobson |first4=Richard |title=Davidson's Principles and Practice of Medicine E-Book |date=2018 |publisher=Elsevier Health Sciences |isbn=9780702070266 |page=227 |url=https://books.google.com/books?id=v3VKDwAAQBAJ&pg=PA227 |language=en}}</ref>
| risks = [[immunodeficiency|Poor immune function]] such as from [[diabetes]] or [[cancer]], [[obesity]], [[alcoholism]], [[intravenous drug use]], [[peripheral artery disease]]<ref name=Hak2014/><ref name=CDC2016/>
| diagnosis = Based on symptoms, [[medical imaging]]<ref name=Paz2014/>
| differential = [[Cellulitis]], [[pyomyositis]], [[gas gangrene]], [[toxic shock syndrome]] or [[toxic shock-like syndrome]], [[pyoderma gangrenosum]], [[deep vein thrombosis]], [[Mucormycosis]], [[brown recluse spider bite]]<ref name=Fer2014>{{cite book |last1=Ferri |first1=Fred F. |title=Ferri's Clinical Advisor 2014 E-Book: 5 Books in 1 |date=2013 |publisher=Elsevier Health Sciences |isbn=978-0323084314 |page=767 |url=https://books.google.com/books?id=H63KViNwsdcC&pg=PA767 |language=en}}</ref>
| prevention = [[Wound care]], [[handwashing]]<ref name=CDC2016/>
| treatment = [[debridement|Surgery to remove the infected tissue]], intravenous [[antibiotic]]s<ref name=Hak2014/><ref name=CDC2016/>
| medication = 
| prognosis = ~30% mortality with treatment,<ref name=Hak2014/> ~100% mortality without treatment
| frequency = 0.7 per 100,000 per year<ref name=Paz2014/>
| deaths = 
}}
[[File:Blackish discolouration with vesicle formation on the thigh NF.webp|thumb|Blackish discoloration with vesicle formation on the thigh in a case of necrotizing fasciitis]]<!-- Definition and symptoms -->
'''Necrotizing fasciitis''' ('''NF'''), also known as '''flesh-eating disease''', is an [[infection]] that kills the body's [[soft tissue]].<ref name="CDC2016">{{cite web |date=September 8, 2023 |title=Necrotizing Fasciitis |url=https://rarediseases.org/rare-diseases/necrotizing-fasciitis/ |archive-url= |archive-date= |access-date=December 3, 2024 |website=NORD}}</ref> It is a serious disease that begins and spreads quickly.<ref name=CDC2016/> Symptoms include red or purple or black skin, swelling, severe pain, [[fever]], and vomiting.<ref name=CDC2016/> The most commonly affected areas are the [[limb (anatomy)|limbs]] and [[perineum]].<ref name=Hak2014/>

<!-- Cause and diagnosis -->
Bacterial infection is by far the most common cause of necrotizing fasciitis.  Despite being called a "flesh-eating disease", bacteria do not eat human tissue. Rather, they release toxins that cause tissue death. Typically, the infection enters the body through a break in the skin such as a cut or [[burn]].<ref name=CDC2016/> Risk factors include recent trauma or surgery and [[immunodeficiency|a weakened immune system]] due to [[diabetes]] or [[cancer]], [[obesity]], [[alcoholism]], [[intravenous drug use]], and [[peripheral artery disease]].<ref name="CDC2016" /><ref name=Hak2014/> It does not usually spread between people.<ref name=CDC2016/> The disease is classified into four types, depending on the infecting organisms.<ref name=Paz2014/>  [[Medical imaging]] is often helpful to confirm the diagnosis.<ref name=Paz2014>{{cite journal|last1=Paz Maya|first1=S|last2=Dualde Beltrán|first2=D|last3=Lemercier|first3=P|last4=Leiva-Salinas|first4=C|title=Necrotizing fasciitis: an urgent diagnosis|journal=Skeletal Radiology|date=May 2014|volume=43|issue=5|pages=577–589|pmid=24469151|doi=10.1007/s00256-013-1813-2|s2cid=9705500|doi-access=free}}</ref><!-- Quote = Imaging is very useful to confirm the diagnosis -->

<!-- Treatment -->
Necrotizing fasciitis is treated with [[debridement|surgery to remove the infected tissue]], and [[antibiotic]]s.<ref name="Hak2014">{{cite journal |last1=Hakkarainen |first1=Timo W. |last2=Kopari |first2=Nicole M. |last3=Pham |first3=Tam N. |last4=Evans |first4=Heather L. |year=2014 |title=Necrotizing soft tissue infections: Review and current concepts in treatment, systems of care, and outcomes |journal=Current Problems in Surgery |language=en-US |volume=51 |issue=8 |pages=344–362 |doi=10.1067/j.cpsurg.2014.06.001 |pmc=4199388 |pmid=25069713}}</ref><ref name=CDC2016/> It is considered a surgical emergency. Delays in surgery are associated with a much higher risk of death.<ref name=Paz2014/> Despite high-quality treatment, the risk of death remains between 25 and 35%.<ref name=Hak2014/>