The case of the Georgia woman with “flesh-eating bacteria” and subsequent cases of necrotizing fasciitis have dominated the news. What should you know? Christine Zurawski, M.D., infectious disease specialist at Piedmont, gives us the facts in this Q&A.
With all the media attention on the local case and other cases of “flesh-eating bacteria,” is there cause for alarm in your opinion?
There is no cause for alarm. Cases of necrotizing fasciitis happen all the time. Although it does not happen every day, it is not uncommon. It just seems like there are a lot of cases because they are being reported to the public. This is not a new or unusual disease.
Is there a simple way to explain what “flesh-eating bacteria” are?
“Flesh-eating bacteria” is a layman's term commonly used to describe infection caused by Group A Streptococci. It got this term due to the bacteria's effect on the body. Necrotizing fasciitis is a disease, and "Flesh-eating bacteria" is only one cause of this disease. The media has been using these terms interchangeably, and they are not the same thing.
This has led to confusion and a misrepresentation of the cases reported in the news. Not all of the cases of necrotizing fasciitis in the news have been caused by the same bacteria. They are all isolated cases, and therefore, they should not be represented as some type of epidemic that has emerged.
What causes necrotizing fasciitis?
Many different types of bacteria can cause necrotizing fasciitis. Most commonly, it is caused by Group A Strep, but other kinds of strep and staph can also cause this disease. The bacteria that caused the disease in the Georgia woman who has been in the news is very unusual. The bacteria gains entry into the body, usually from some type of trauma, such as a cut or simply a fall.
The bacteria gets into the layers of tissue between the skin and the muscle called fascia. The bacteria produces toxins that cause the tissue to die rapidly. This is why surgery is required to prevent the tissue damage from continuing to travel up the limbs.
Why does treatment seem to be so difficult?
The bacteria is not actually “eating the flesh.” The bacteria is not resistant to the antibiotics. The toxins produced by the bacteria initiate a cascade of events in the immune system that cause the body to be unable to stop the tissue damage.
This process is not easily “turned off.” Even after you kill the bacteria, this process and the effects of the toxins are difficult to interrupt.
Are there ways we can prevent becoming infected?
No. Different types of bacteria can cause necrotizing fasciitis, and they are all part of our environment. Not every infection with one of these organisms results in this disease. These bacteria often cause a simple skin infection and can be treated with common antibiotics.
What are the tell-tale signs?
The hallmark symptom is severe pain. Fever, redness and obvious signs of infection are sometimes not apparent until later. The pain is almost always way out of proportion to whatever the injury is. If you drop something heavy on your foot, the foot may look OK or have a small bruise.
It may hurt for a while, but it should stop. If the foot starts to swell, and the pain is so severe that you cannot walk and it becomes unbearable, this should be a cause for concern and should be evaluated by a healthcare provider.
Need to make an appointment with a Piedmont physician? Save time, book online.