Necrotizing fasciitis: What is this flesh-eating disease? What are the signs? How do you treat it?

ORLANDO, Fla. - How did an 11-year-old boy die days after he twisted his ankle? Doctors believe he contracted an infection through a scratch that became necrotizing fasciitis, a rare bacteria that attacks tissues, and is commonly known as a "flesh-eating disease."

According to his family, Jesse Brown twisted his ankle while on the treadmill and may have had a scratch during the incident. Days later, his leg became splotchy and had purple and red marks, similar to a bruise. He was diagnosed with Group A strep, which then became necrotizing fasciitis, his family said.

What is Group A strep? What is Necrotizing fasciitis? What are the signs to know, and how do you treat it?

What is Group A strep?

According to the Centers for Disease Control and Prevention (CDC), Group A strep is a bacteria that can cause many different infections, including strep throat, Scarlet fever, and necrotizing fasciitis. 

The CDC said it is also looking into an increase of invasive Group A strep (iGAS) cases among children, which were low during the COVID-19 pandemic, but have returned to pre-pandemic levels. 

"Invasive disease means that germs invade parts of the body that are normally free from germs. When this happens, disease is usually very severe," according to the CDC's website.

According to preliminary data from 2022, cases of iGAS increased earlier in the season (September and November) vs. December-April during a typical year, the CDC said. The cases also occurred during a time when there were more reports of influenza, RSV, and less severe strep throat.

According to the CDC, there are between 700 and 1,150 cases each year in the U.S., which is "likely an underestimate."  

According to the Florida Department of Health's website, 

What is necrotizing fasciitis? How do you get it?

The CDC describes necrotizing fasciitis as "a rare bacterial infection that spreads quickly in the body and can cause death." There are many types of bacteria that can cause necrotizing fasciitis, but quick and accurate medical diagnosis and treatment are important, the CDC said.

The bacteria that causes the disease commonly enters the body through a break in the skin:

• Cuts and scrapes
• Burns
• Insect bites
• Puncture wounds (including IV drug use)
• Surgical wounds

What are the signs and symptoms of necrotizing fasciitis?

According to the CDC, preliminary signs and symptoms of necrotizing fasciitis include:

• A red, warm, or swollen area of skin that spreads quickly
• Severe pain, including pain beyond the area of the skin that is red, warm, or swollen
• Fever

Additional symptoms include:

• Ulcers, blisters, or black spots on the skin
• Changes in the color of the skin
• Pus or oozing from the infected area
• Dizziness
• Fatigue (tiredness)
• Diarrhea or nausea

How common is necrotizing fasciitis?

Health officials said the disease is rare but, some people are at an increased risk. Those who get the illness typically have other health problems that may lower their body's ability to fight infections, such as diabetes, kidney disease, Cirrhosis (scarring) of the liver and cancer. 

Dr. Candice Jones, an Orlando pediatrician, said there’s been a recent uptick in invasive Strep-A cases among kids in the U.S.

Serious complications are common, according to the CDC, and can include sepsis, shock, organ failure, loss of limbs, scarring, and death.

What are the symptoms to look for?

If a Group A strep diagnosis turns into a flesh-eating bacteria, early symptoms can include:

• A red, warm, or swollen area of skin that spreads quickly
• Severe pain, including pain beyond the area of the skin that is red, warm, or swollen
• Fever

Later symptoms of it can include:

• Ulcers, blisters, or black spots on the skin
• Changes in the color of the skin
• Pus or oozing from the infected area
• Dizziness
• Fatigue (tiredness)
• Diarrhea or nausea

How do you treat necrotizing fasciitis?

There are no vaccines to prevent group A strep infections or necrotizing fasciitis. However, the CDC recommends to ways to help prevent contracting an infection:

• Wash hands often with warm soap and water, or use an alcohol-based hand rub or sanitizer
• Clean wounds with soap and water (ie: blisters and scrapes)
• Bandage wounds
• See a doctor for puncture, deep, or serious injuries