Necrotizing Fasciitis Quiz
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Redness of the skin
Have a fever
Muscle pain in the limbs when pressed or squeezed
There are blisters
Swelling of the affected area
Red spots on skin
My body is hot
Not seeing your symptoms? No worries!
What is Necrotizing Fasciitis?
This is a serious and potentially fatal bacterial infection that affects the deeper layers of the skin. Patients with poorly managed diabetes and a weak immune system are at a higher risk.
Typical Symptoms of Necrotizing Fasciitis
- Fever
- Blisters on the skin
- Swelling in the affected area
- Muscle pain in the limbs when pressed or squeezed
- Skin problems
- Pain or discomfort in arms or legs
- History of diabetes or pre-diabetes
- Redness, bumps, or irritation on the skin
Diagnostic Questions for Necrotizing Fasciitis
Your doctor may ask these questions to check for this disease:
- Do you have a fever?
- Do you have any blisters on your skin?
- Do you have swelling in the affected area?
- Do you feel pain in your arm and leg when they are grasped?
- Do you have any skin problems
Treatment of Necrotizing Fasciitis
This requires urgent medical care for early surgery and powerful injectable antibiotics. Sometimes, multiple surgeries are needed to control the infection.
Reviewed By:
Maxwell J. Nanes, DO (Emergency Medicine)
Dr Nanes received a doctorate from the Chicago College of Osteopathic Medicine and went on to complete a residency in emergency medicine at the Medical College of Wisconsin. There he trained at Froedtert Hospital and Children's Hospital of Wisconsin in the practice of adult and pediatric emergency medicine. He was a chief resident and received numerous awards for teaching excellence during his time there. | | After residency he took a job at a community hospital where he and his colleagues worked through the toughest days of the COVID-19 pandemic. |
Yukiko Ueda, MD (Dermatology)
Dr. Ueda graduated from the Niigata University School of Medicine and trained at the University of Tokyo Medical School. She is currently a clinical assistant professor at the Department of Dermatology, Jichi Medical University, and holds several posts in the dermatology departments at Kyoto Prefectural University of Medicine, Komagome Hospital, University of Tokyo, and the Medical Center of Japan Red Cross Society.
Content updated on Feb 13, 2025
Following the Medical Content Editorial Policy
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People with similar symptoms also use Ubie's symptom checker to find possible causes
- Swollen area
- Recurrent fevers
- Squeezing the muscles of the arms or legs causes pain
- Lip blister
- Periodic fever (>100.4°F / 38°C)
- Rashes
- Fever then no fever then fever again
- Painful blisters
- Remittent fever of 102.2°F / 39°C
- Extremely high fever of 106.7°F / 41.5°C or higher
- Clear liquid in a blister
- Fever of 100.4°F / 38°C or more for weeks
- Stomach was uncomfortable, then had a fever
- Leg rash
- Shingles-like rash on the skin
See full list
Symptoms Related to Necrotizing Fasciitis
Diseases Related to Necrotizing Fasciitis
FAQs
Q.
Rapid Redness? Why Your Skin Is Failing: Necrotizing Fasciitis & Medical Steps
A.
Rapidly spreading skin redness with severe pain that seems out of proportion, fever, blisters, or skin turning purple or black can indicate necrotizing fasciitis, a rare but life threatening infection that can worsen within hours and needs immediate emergency care with IV antibiotics and urgent surgery. There are several factors to consider. See below for the full warning signs, who is at higher risk, what is probably not this condition, and the precise next steps that could change your care plan.
References:
* Sarani B, Strong M, Feliciano DV, Gardner TB. Necrotizing Fasciitis: an overview. Crit Care Med. 2021 Jan;49(1):97-109. doi: 10.1097/CCM.0000000000004734. PMID: 33315758.
* Zayyad LN, Johnson EA, O'Connor AD, Gupta AK, Hentel VL, Johnson PD, Kim HC. Necrotizing Fasciitis: Pathogenesis, Diagnosis, and Management. Am J Med Sci. 2021 May;361(5):590-600. doi: 10.1016/j.amjms.2021.01.006. PMID: 33853612.
* Young PL, Chen LC, Cheng RCG. Necrotizing soft tissue infections: current management and future directions. J Hosp Infect. 2022 Nov;129:10-21. doi: 10.1016/j.jhin.2022.08.006. PMID: 36007677.
* Adelman EE, Mccormick PJ, Kim HC. Necrotizing soft tissue infections. Curr Opin Crit Care. 2023 Aug 1;29(4):307-313. doi: 10.1097/MCC.0000000000001046. PMID: 37370891.
* Wong CH, Chang HC, Pasupathy S, Khin LW, Tan JL, Low CO. Necrotizing fasciitis: clinical presentation, microbiology, and outcomes. Surg Infect (Larchmt). 2003 Jun;4(2):149-56. doi: 10.1089/109662903322108740. PMID: 12908824.
Q.
Is it Degloving? Why Your Skin Separates and Critical Medical Next Steps
A.
Degloving is a medical emergency where skin and soft tissue are torn from deeper structures, sometimes hidden internally as a closed lesion. It requires immediate ER care due to bleeding, loss of blood supply, and high infection risk, with red flags like peeled-back skin or exposed tissue, rapidly enlarging squishy swelling after trauma, spreading bruising or discoloration, numbness, and severe or worsening pain. There are several factors to consider. See below for urgent first steps, when to get imaging, surgical options like debridement, reattachment, grafts or flaps, and infection warning signs including necrotizing fasciitis, plus recovery timelines that can guide your next decisions.
References:
* Latif, M., et al. Degloving injuries: a systematic review and meta-analysis. *World J Emerg Surg*. 2020 Apr 20;15(1):28. PMID: 32308670. Available from: pubmed.ncbi.nlm.nih.gov/32308670/
* Hak, A., et al. Degloving injuries: An up-to-date review. *Int J Surg*. 2024 Mar;112:107052. PMID: 38246376. Available from: pubmed.ncbi.nlm.nih.gov/38246376/
* Babamahmodi, A., et al. Degloving injuries: classification and management. *J Injury Violence Res*. 2019 Jul;11(3):149-158. PMID: 31885488. Available from: pubmed.ncbi.nlm.nih.gov/31885488/
* Dini, M., et al. Management of Degloving Injuries of the Extremities: A Review of Reconstruction Options. *J Reconstr Microsurg*. 2018 Feb;34(2):101-110. PMID: 29281987. Available from: pubmed.ncbi.nlm.nih.gov/29281987/
* Kudlinski, L., et al. Degloving Injuries: Anatomy, Classification, Diagnosis, and Management. *Plast Reconstr Surg Glob Open*. 2018 May 10;6(5):e1781. PMID: 29849929. Available from: pubmed.ncbi.nlm.nih.gov/29849929/
Q.
Is it Necrosis? Why Your Tissue is Dying and Medically Approved Next Steps
A.
Necrosis means tissue is dying due to lost blood flow, severe infection, toxins, or trauma, and it can progress fast; watch for dark or pale skin changes, severe or worsening pain, foul-smelling drainage, numbness, fever, or rapidly spreading redness. Early medical care is essential because dead tissue cannot recover and treatment focuses on stopping spread, treating the cause, and sometimes surgical removal; there are several factors to consider. See complete warning signs, who is at risk, and step by step next actions below.
References:
* Chen X, Tang S, Ding T, Liu H. Ferroptosis, necroptosis, and pyroptosis: new insights into the pathogenesis and treatment of diseases. Cell Biol Toxicol. 2022 Jun;38(3):363-380. doi: 10.1007/s10565-021-09670-w. Epub 2021 Jul 26. PMID: 34312891.
* Hageman MGJS, Hehenkamp D, Buiting AG, Dellinger EP, Doudle F, Furtan F, Geenen B, Gerich M, Gordon N, Jochymczyk M, Kastenbauer E, Langenfeld PJ, Lecky F, Mair M, Martin M, Mattar B, Mertz M, Piening M, Radojewski P, Rosskopf M, Stämpfli T, Tscherne B, Urner M, van Leeuwen BL. Necrotizing soft tissue infections (NSTI): Current concepts of diagnosis and management. World J Emerg Surg. 2023 Feb 11;18(1):15. doi: 10.1186/s13017-023-00481-6. PMID: 36774618; PMCID: PMC9922005.
* Li F, Cai Y, Wu Y, Yang J, Meng G, Yang X, Li Q. Pathogenesis and therapeutic targets of ischemic reperfusion injury. Signal Transduct Target Ther. 2021 Mar 19;6(1):108. doi: 10.1038/s41392-021-00512-6. PMID: 33741913; PMCID: PMC7977464.
* Serena T, DaVanzo W, Armstrong DG. Debridement of Chronic Wounds: The Impact of Surgical and Non-Surgical Debridement on Wound Healing. Wounds. 2020 May;32(5):125-133. PMID: 32437340.
* Zheng M, Zhang W, Zou H, Li J. Programmed Necrosis: A Promising Therapeutic Target for Cancer and Inflammatory Diseases. Front Cell Dev Biol. 2021 Apr 22;9:670274. doi: 10.3389/fcell.2021.670274. PMID: 33968798; PMCID: PMC8102324.
Q.
Is it Necrosis? Why Your Tissue is Dying & Medical Next Steps
A.
Necrosis is tissue death caused by lost blood flow, severe infection, major injury, toxins, or extreme temperatures, and it often demands urgent care when pain is severe, redness or swelling spreads quickly, fever develops, or skin turns black or gray. Next steps depend on the cause and may include restoring circulation, IV antibiotics, surgical removal of dead tissue, and specialized wound care, with early evaluation key to preventing sepsis, organ damage, or amputation. There are several factors to consider, including specific signs, tests, and treatments, so see the complete details below to guide your next medical steps.
References:
* Pasparakis M, Vandenabeele P, Vanden Berghe T. The multifaceted roles of necrosis in human diseases. Nat Rev Pathol. 2023 Nov;20(11):733-751. doi: 10.1038/s41572-023-00473-5. Epub 2023 Aug 24. PMID: 37620023.
* Denisa et al. Necrosis: Molecular Mechanisms and Pathological Consequences. Cell Death Dis. 2019 Jan 25;10(2):65. doi: 10.1038/s41419-019-1323-y. PMID: 30678229; PMCID: PMC6347317.
* Vanden Berghe T, Kaiser WJ, Festjens E, van Loo G, Saelens X, Vandenabeele P. Programmed necrosis: a master switch to inflammation. Cell Death Differ. 2012 Jan;19(1):11-20. doi: 10.1038/cdd.2011.146. PMID: 22027961; PMCID: PMC3245464.
* Gong Y, Cao H, Sun X, Zhang J, Li Y, Han X, Li B, Zhang B. Current Understanding of Necroptosis: Molecular Mechanisms and Therapeutic Targets. Int J Mol Sci. 2022 Jul 29;23(15):8435. doi: 10.3390/ijms23158435. PMID: 35928643; PMCID: PMC9368545.
* Romanelli M, Dini V, Lazzerini F, Brini A, Colombo M. Wound care management in patients with chronic wounds complicated by necrosis: current evidence and future perspectives. J Wound Care. 2022 Mar 2;31(3):278-283. doi: 10.12968/jowc.2022.31.3.278. PMID: 35265555.
Q.
Can you get flesh-eating bacteria from fresh water?
A.
Yes, flesh-eating bacteria can be found in fresh water, but it is rare.
References:
Rossi F, Santonicola S, Amadoro C, Marino L, & Colavita G. (2023). Recent Records on Bacterial Opportunistic Infections via .... Microorganisms, 38257896.
https://pubmed.ncbi.nlm.nih.gov/38257896/
Love DC, Lovelace GL, & Sobsey MD. (2010). Removal of Escherichia coli, Enterococcus fecalis .... International journal of food microbiology, 20864199.
https://pubmed.ncbi.nlm.nih.gov/20864199/
Cetron MS, Chitsulo L, Sullivan JJ, Pilcher J, Wilson M, Noh J, et al. (1996). Schistosomiasis in Lake Malawi. Lancet (London, England), 8909380.
Q.
Do you need an open wound to get flesh-eating bacteria?
A.
You usually need an open wound to get flesh-eating bacteria, as these bacteria often enter through cuts or sores.
References:
Mphande AN, Killowe C, Phalira S, Jones HW, & Harrison WJ. (2007). Effects of honey and sugar dressings on wound healing. Journal of wound care, 17708384.
https://pubmed.ncbi.nlm.nih.gov/17708384/
Baumgardner DJ. (2012). Soil-related bacterial and fungal infections. Journal of the American Board of Family Medicine : JABFM, 22956709.
Q.
How can I protect myself from flesh-eating bacteria?
A.
To protect yourself from flesh-eating bacteria, avoid exposure to contaminated water and maintain good hygiene, especially if you have cuts or wounds.
References:
Williams LB, Haydel SE, Giese RF, & Eberl DD. (2008). CHEMICAL AND MINERALOGICAL CHARACTERISTICS .... Clays and clay minerals, 19079803.
https://pubmed.ncbi.nlm.nih.gov/19079803/
Park SD, Shon HS, & Joh NJ. (1991). Vibrio vulnificus septicemia in Korea: clinical and .... Journal of the American Academy of Dermatology, 2061435.
https://pubmed.ncbi.nlm.nih.gov/2061435/
May J, Chan CH, King A, Williams L, & French GL. (2000). Time-kill studies of tea tree oils on clinical isolates. The Journal of antimicrobial chemotherapy, 10797086.
Q.
How do you catch flesh-eating bacteria?
A.
Flesh-eating bacteria, or necrotizing fasciitis, can be caught through cuts or wounds that come into contact with certain bacteria, often found in soil.
References:
Baumgardner DJ. (2012). Soil-related bacterial and fungal infections. Journal of the American Board of Family Medicine : JABFM, 22956709.
Q.
How quickly does flesh-eating bacteria kill?
A.
Flesh-eating bacteria can be very dangerous and can lead to death quickly, sometimes within a few days, if not treated promptly.
References:
Henrich DE, Smith TL, & Shockley WW. (1995). Fatal craniocervical necrotizing fasciitis in an .... Head & neck, 7672978.
https://pubmed.ncbi.nlm.nih.gov/7672978/
Farah R, & Asla H. (2016). [NECROTIZING FASCIITIS OF THE CHEST WALL]. Harefuah, 27323534.
https://pubmed.ncbi.nlm.nih.gov/27323534/
Park SD, Shon HS, & Joh NJ. (1991). Vibrio vulnificus septicemia in Korea: clinical and .... Journal of the American Academy of Dermatology, 2061435.
Q.
What are the early signs of flesh-eating bacteria?
A.
Early signs of flesh-eating bacteria, or necrotizing fasciitis, include redness, swelling, and pain in the affected area, which can quickly worsen.
References:
Hua J, & Friedlander P. (2023). Cervical Necrotizing Fasciitis, Diagnosis and Treatment .... Ear, nose, & throat journal, 33570428.
https://pubmed.ncbi.nlm.nih.gov/33570428/
Yu KH, Ho HH, Chen JY, & Luo SF. (2004). Gout complicated with necrotizing fasciitis--report of 15 cases. Rheumatology (Oxford, England), 14722350.
https://pubmed.ncbi.nlm.nih.gov/14722350/
Swaminath D, Narayanan R, Orellana-Barrios MA, & Temple B. (2014). Necrotizing fasciitis of the nose complicated with .... Case reports in infectious diseases, 24876978.
Q.
What are the serious complications of flesh-eating bacteria?
A.
Flesh-eating bacteria can lead to severe complications like tissue death, organ failure, and even death if not treated quickly.
References:
Light TD, Choi KC, Thomsen TA, Skeete DA, Latenser BA, Born JM, et al. (2010). Long-term outcomes of patients with necrotizing fasciitis. Journal of burn care & research : official publication of the American Burn Association, 20061842.
https://pubmed.ncbi.nlm.nih.gov/20061842/
Mudhol RR, Lingamaneni S, Sheelin S, & Vallabha A. (2024). Enterococcus necrotising fasciitis of the face after minor .... BMJ case reports, 39694659.
https://pubmed.ncbi.nlm.nih.gov/39694659/
Nagayama J, Sato T, Takanori I, Kouji K, & Mitsunobu N. (2024). Necrotising fasciitis with extensive necrosis caused by .... BMC infectious diseases, 38649870.
Q.
What are the signs of flesh-eating bacteria infection?
A.
Flesh-eating bacteria infection, also known as necrotizing fasciitis, often starts with sudden pain and swelling, and the skin may turn red or purple. It can quickly lead to severe illness, so it's important to seek medical help right away if these signs appear.
References:
García-Casares E, Mateo Soria L, García-Melchor E, Riera Alonso E, Olivé Marqués A, Holgado Pérez S, et al. (2010). Necrotizing fasciitis and myositis caused by streptococcal .... Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases, 21085016.
https://pubmed.ncbi.nlm.nih.gov/21085016/
Stevens DL. (1999). The flesh-eating bacterium: what's next?. The Journal of infectious diseases, 10081509.
https://pubmed.ncbi.nlm.nih.gov/10081509/
Quirk WF Jr, & Sternbach G. (1996). Joseph Jones: infection with flesh eating bacteria. The Journal of emergency medicine, 8969999.
Q.
What is necrotizing fasciitis caused by flesh-eating bacteria?
A.
Necrotizing fasciitis is a serious infection where bacteria destroy skin and tissue, often caused by Vibrio vulnificus. It spreads quickly and needs urgent medical care.
References:
Kuo YL, Shieh SJ, Chiu HY, & Lee JW. (2007). Necrotizing fasciitis caused by Vibrio vulnificus. European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology, 17674061.
https://pubmed.ncbi.nlm.nih.gov/17674061/
Fujisawa N, Yamada H, Kohda H, Tadano J, & Hayashi S. (1998). Necrotizing fasciitis caused by Vibrio vulnificus differs from .... The Journal of infection, 9661943.
https://pubmed.ncbi.nlm.nih.gov/9661943/
Myers CM, Miller JJ, & Davis WD. (2019). Skin and Soft Tissue Infections: A Case of Necrotizing .... Advanced emergency nursing journal, 31687996.
Q.
What is the survival rate for flesh-eating bacteria infection?
A.
The survival rate for necrotizing fasciitis, or flesh-eating bacteria infection, can vary, but it is generally serious with significant risk of death.
References:
Light TD, Choi KC, Thomsen TA, Skeete DA, Latenser BA, Born JM, et al. (2010). Long-term outcomes of patients with necrotizing fasciitis. Journal of burn care & research : official publication of the American Burn Association, 20061842.
https://pubmed.ncbi.nlm.nih.gov/20061842/
Cheng NC, Wang JT, Chang SC, Tai HC, & Tang YB. (2011). Necrotizing fasciitis caused by Staphylococcus aureus. Annals of plastic surgery, 21407055.
https://pubmed.ncbi.nlm.nih.gov/21407055/
Legbo JN, & Shehu BB. (2005). Necrotizing fasciitis: a comparative analysis of 56 cases. Journal of the National Medical Association, 16396062.
Q.
What is Vibrio vulnificus bacteria?
A.
Vibrio vulnificus is a type of bacteria found in warm seawater that can cause severe illness in humans, especially if it enters through cuts or is ingested with contaminated seafood.
References:
Heng SP, Letchumanan V, Deng CY, Ab Mutalib NS, Khan TM, Chuah LH, et al. (2017). Vibrio vulnificus: An Environmental and Clinical Burden. Frontiers in microbiology, 28620366.
https://pubmed.ncbi.nlm.nih.gov/28620366/
Baker-Austin C, & Oliver JD. (2018). Vibrio vulnificus: new insights into a deadly opportunistic .... Environmental microbiology, 29027375.
https://pubmed.ncbi.nlm.nih.gov/29027375/
Candelli M, Sacco Fernandez M, Triunfo C, Piccioni A, Ojetti V, Franceschi F, & Pignataro G. (2025). Vibrio vulnificus-A Review with a Special Focus on Sepsis. Microorganisms, 39858896.
Q.
What should I do if I think I have flesh-eating bacteria?
A.
If you think you have flesh-eating bacteria, it is important to seek medical help immediately, as it can be very serious.
References:
Quirk WF Jr, & Sternbach G. (1996). Joseph Jones: infection with flesh eating bacteria. The Journal of emergency medicine, 8969999.
https://pubmed.ncbi.nlm.nih.gov/8969999/
Yu KH, Ho HH, Chen JY, & Luo SF. (2004). Gout complicated with necrotizing fasciitis--report of 15 cases. Rheumatology (Oxford, England), 14722350.
Q.
Where is flesh-eating bacteria found in water?
A.
Flesh-eating bacteria, which can cause severe infections, are often found in water environments, particularly in warm coastal waters.
References:
Quirk WF Jr, & Sternbach G. (1996). Joseph Jones: infection with flesh eating bacteria. The Journal of emergency medicine, 8969999.
https://pubmed.ncbi.nlm.nih.gov/8969999/
García-Casares E, Mateo Soria L, García-Melchor E, Riera Alonso E, Olivé Marqués A, Holgado Pérez S, et al. (2010). Necrotizing fasciitis and myositis caused by streptococcal .... Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases, 21085016.
https://pubmed.ncbi.nlm.nih.gov/21085016/
Madiyal M, Eshwara VK, Halim I, Stanley W, Prabhu M, & Mukhopadhyay C. (2016). A rare glimpse into the morbid world of necrotising fasciitis. Indian journal of medical microbiology, 27514968.
Q.
Who is most at risk for severe flesh-eating bacteria infection?
A.
People most at risk for severe flesh-eating bacteria infections are those with weakened immune systems or existing health problems.
References:
Quirk WF Jr, & Sternbach G. (1996). Joseph Jones: infection with flesh eating bacteria. The Journal of emergency medicine, 8969999.
https://pubmed.ncbi.nlm.nih.gov/8969999/
Rossi F, Santonicola S, Amadoro C, Marino L, & Colavita G. (2023). Recent Records on Bacterial Opportunistic Infections via .... Microorganisms, 38257896.
https://pubmed.ncbi.nlm.nih.gov/38257896/
Baumgardner DJ. (2012). Soil-related bacterial and fungal infections. Journal of the American Board of Family Medicine : JABFM, 22956709.
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Shetty, D., Desai, A., & Kumar, N. (2022). Necrotizing fasciitis of the face: The flesh eating catastrophic malady. Malta Medical Journal.
http://www.mmsjournals.org/index.php/mmj/article/view/495Torjesen, I. (2018). Epidemic of flesh eating tropical ulcers hits Australia. BMJ: British Medical Journal (Online).
https://search.proquest.com/openview/abe08cad10123d418f3998435a31aead/1?pq-origsite=gscholar&cbl=2043523Mondragon-Shem, K., & Acosta-Serrano, A. (2016). Cutaneous leishmaniasis: The truth about the 'Flesh-Eating Disease' in Syria. Trends in Parasitology.
https://www.cell.com/trends/parasitology/fulltext/S1471-4922(16)00045-3