Necrotising fasciitis, a flesh eating bug, sounds like something from a horror movie but this condition was very much real for Simon English of Beverley, East Yorkshire and caused his to suffer devastating and life changing injuries.  

It is a rare and life threatening bacterial infection that can happen if a wound gets infected. Group A Streptococcus bacteria the most common bacteria involved with necrotising fasciitis but it can be caused by many different types of bacteria.  

The infection can get into the body through any type of wound, even very small ones, such as cuts and scratches, burns and scalds, insect bites, surgery and injecting drugs, and the infection then spreads through the fascia, which is the layer of tissue under the skin. As the infection spreads, it causes damage to the soft tissues and can enter the blood stream.  

It gets worse very quickly and can be fatal if not treated with sufficient urgency. If there is a delay with diagnosis and treatment, this can allow the infection to spread and this can result in devastating consequences, including amputation of limbs and development of toxic shock syndrome, which can be fatal. Delay in treatment can allow sepsis to develop, this happening when the bacteria enters the bloodstream. Sepsis is the body’s attempt to fight the infection but which causes injury to its own tissues and organs in the process. This can also be fatal and indeed, one in 5 patients who suffer necrotising fasciitis will die.   

For Simon, he fortunately survived but he spent 3 months in intensive care and had to have an emergency colostomy operation to form a stoma to allow his wound to heal. His necrotising fasciitis entered his body through a very small wound on his left buttock and he described the infection as ‘chewing through his buttocks like a shark’. 

It is vital that healthcare practitioners are alert to the risk of necrotising fasciitis, as the symptoms can be similar to much more common skin conditions, such as cellulitis. The key difference between necrotising fasciitis and other more common skin conditions is that necrotising fasciitis is a medical emergency and needs to be treated in hospital immediately. 

The initial symptoms of necrotising fasciitis include: 

• intense pain or loss of feeling near to a cut or wound – the pain may seem much worse than you would usually expect from a cut or wound 

• swelling of the skin around the affected area 

• flu-like symptoms, such as a high temperature, headache and tiredness 

Later symptoms can include: 

• being sick and diarrhoea 

• confusion 

• black, purple or grey blotches and blisters on the skin (these may be less obvious on black or brown skin) 

Diagnosis is typically made based upon the clinical symptoms, although investigations such as blood tests and tissue cultures can help to support a diagnosis. However, healthcare professionals should not await investigation results before referring patients for treatment, such is the urgent need for treatment.  

Treatment is usually antibiotics and surgery to remove the affected area. Antibiotics should be started intravenously as a matter of urgency to target the infection and they can then be tailored to the specific bacteria causing the infection once culture results are available. The surgery is called a fasciotomy and multiple surgeries may be required to control the infection and remove all of the dead tissue. Skin grafts may be needed to help close the wounds from the fasciotomy.  

If you or a loved one have suffered necrotising fasciitis and feel that there was a delay or issue concerning diagnosis or treatment, please contact our experienced medical negligence team to discuss how we can assist.