After an injury can cause a serious infection with what the flesh-eating bacteria is called in the vernacular: necrotizing fasciitis. This usually involves an infection with group A streptococcus, but other bacteria often to do with it. Treating quickly it is necessary, in combination with surgery. Fortunately, this condition is relatively rare.
Photo: Streptococcus pyogenes
Necrotizing fasciitis or necrotizing fasciitis is an acute, intense running inflammation of the subcutaneous tissue. It is characteristic that there is necrosis and gangrene of tissue occurs, and this is rapidly expanding in the course of the next few hours. The tissues which are hereby affected part of the skin, the muscles, the subcutaneous fat and connective tissues.
This infection starts initially at a local injury of the skin and on the legs is more common for it. It may seem at first to erysipelas or erysipelas, but the pain is very intense for the size of the wound appears to be. Also, the skin hot and red, very sensitive to pressure, there has been large and small blisters filled with fluid, the whole infected area will swell. The redness can spread very quickly. If the infection is not so obvious on the surface but lies deeper, there is often nothing to see.
Other symptoms that most patients receive - in addition to the severe pain - are diarrhea, nausea, vomiting. In infections which are located on the surface it can be seen that the skin changes color from red to violet and then to brown to black. This is the stage of necrosis, death of the tissue. The gangrene, dissolution, with the formation of gas in the tissues can occur in the fourth to fifth day. Often arise there are abscesses in the infected area. In this stage, the patient has a high fever, and feel very sick, with chills, headache. Also occur more serious symptoms, such as low blood pressure, rapid heart rate and difficulty breathing. The infection spreads in 24 to 72 hours out very quickly. If there is no treatment is followed by the infection will be lethal.
If the infection is caused by a single bacterial species usually show this to be a bacterium belonging to the Streptococcus: Streptococcus pyogenes, group A streptococcus. For that reason, this bacterium also has the nickname flesh-eating bacteria. In addition, other bacteria are often found taking part in the infection process: including Staphylococcus aureus, E. coli, Pseudomonas aeruginosa Clostridium.
Is then a combination of a number of species have been found as a cause for necrotizing fasciitis; some species thrive in oxygen, while others are better without oxygen. MRSA, the notorious MRSA is also increasingly found here. The bacteria that make toxins which cause the blood vessels to malfunction and die the tissues.
In the treatment speed is of vital importance, and the patient has to be hospitalized before. Through an infusion of antibiotics to be administered in high doses. To stop the infection must be removed by means of operating the affected tissue, whereby even amputation of an arm or leg may be required. The surgery is needed because antibiotics can not be distributed properly by the dead tissue. Later, a skin graft will then be needed in order to be able to cover the operated area permanently good. Sometimes it is also used in the oxygen treatment in order to deal with the anaerobic bacteria.
The longer it takes before starting the treatment, the worse the outlook for the patient. The mortality rate is high: 20 to 40% of the patients dies to it, even with proper treatment. The good news is that it is a relatively rare condition.
People walking likely to get this infection as they have to deal with an injury, such as, for example, a burn, or after a surgical procedure. Therefore people who inject drugs are at greater risk. Also, a pre-existing infection presents greater risk of this infection. Other factors that may play a role include:
age over 60 years
an artificial suppression of the immune system, such as post-transplant
structurally wrong diet
reduced function of the kidneys
certain disorders of the blood vessels
Even with a smaller wound, such as a cut in home-garden and kitchen work in a wound infection can arise, though the culprit is usually Staphylococcus aureus, and takes the infection less dramatic. The chance of a severe infection as described above, is not as high, but it is wise to always treat the wound with antiseptic injury.
Prime Minister Balkenende got this infection in a foot in the autumn of 2004 and then to treat it for weeks in the intensive care unit of the Hospital IJsselland been recorded.