Welcome to The Practical Patient webpage. 

Straight talk about your healthcare.


Flesh-Eating Bacteria: What to Look For

Flesh-Eating Bacteria: What to Look For

Recent headlines have reported illness and death caused by flesh-eating bacteria after exposure to ocean water. This type of infection, called Necrotizing Fasciitis, is a rare cause of illness in the U.S. But there is more than one type of bacteria that is responsible for this life-threatening disease.

Necrotizing means causing the death of tissues. Fasciitis means inflammation of the fascia: the tissue under the skin that surrounds muscles, nerves, fat, and blood vessels. (In raw chicken, this is the slippery, white fibrous tissue that surrounds the muscle.)

Vibrio vulnificus: bacteria

  • A rare cause of illness

  • Natural inhabitant of coastal waters

  • People who develop wound infections generally do so following contamination of a pre-existing wound or through an injury received while exposed to brackish or salt water

  • Very rare among children

Group A Streptococcus: bacteria

  • Most common cause of necrotizing fasciitis

  • Can also cause strep throat, scarlet fever, rheumatic fever, Toxic Shock Syndrome, and impetigo (superficial skin infection)

  • Commonly found in the throat and on the skin (people may be carriers without symptoms)

  • Spread by direct contact with infected nose and throat mucus or with infected skin lesions

Poly-Microbial: many bacteria

  • A combination of bacteria: Anaerobic species (Bacteroides, Clostridium, Peptostreptococcus), Enterobacteriaceae (E. coli, Enterobacter, Klebsiella, Proteus), and one or more anaerobic streptococci other than group A Streptococcus

Exposure: Bacteria most commonly enter through breaks in the skin


  • A red or swollen area of skin that spreads quickly

  • Severe pain, including pain beyond the area of the skin that is red or swollen

  • Fever

Later symptoms

  • Ulcers, blisters, or black spots on the skin

  • Changes in the color of the skin

  • Pus or oozing from the infected area

  • Dizziness

  • Fatigue

  • Diarrhea or nausea

Diagnosis: There are many infections that look similar to necrotizing fasciitis in the early stages

  • Tissue sample (biopsy)

  • Blood work

  • Imaging: CT scan, MRI, ultrasound


  • Sepsis: the infection triggers a chair reaction throughout the body, causing widespread inflammation

  • Shock: lack of blood flow to the body

  • Organ failure

  • Death: 1 in 3 people die of necrotizing fasciitis


  • Antibiotics

  • Surgery

Sometimes antibiotics can’t reach all of the infected areas because bacteria have killed too much tissue and reduced blood flow. When this happens, the dead tissue is surgically removed. It is common for someone with necrotizing fasciitis to end up needing multiple surgeries.

Wound Care

  • Use soap and water to clean all minor cuts and injuries.

  • Clean and cover draining or open wounds with clean, dry bandages until they heal.

  • See your medical provider for puncture and other deep or serious wounds.

If you have an open wound or skin infection, avoid spending time in:

  • Hot tubs

  • Swimming pools

  • Natural bodies of water (lakes, rivers, oceans)

EEE Virus: Mosquito-Borne

EEE Virus: Mosquito-Borne

Fecal Transplant: An Investigational New Drug

Fecal Transplant: An Investigational New Drug