What can you tell us about a skin condition called necrotizing fasciitis? We understand it is fairly rare (our elderly father is in the hospital with this) and can be deadly.

You are right: necrotizing fasciitis (NF) is a rare condition but one that can have deadly consequences. It’s an infection of the soft tissues — primarily the fascia or connective tissue.

NF is caused by a bacteria or fungus — there are over 25 different types known to cause NF. Some of the more common names you may recognize: e coli, staphylococcus, streptococcus, enterococcus. Many times there is more than one organism present contributing to the problem.

There are certain risk factors associated with NF. Most people who develop NF have suffered some type of skin or soft tissue injury or trauma. It can be something as minor as a skin abrasion or scratch, insect bite, or cut.

Chronic skin ulcers, severe burns, open wounds from surgery or other infections can also put a person at increased risk for this condition. Age can be a risk factor. Older adults often experience a decline in their immune system function.

Other known risk factors include diabetes or other chronic diseases, intravenous drug abuse, and immunodeficiency. Immunodeficiency refers to a depressed immune system — usually from something like AIDS, organ transplantation, arthritis, or autoimmune diseases.

Early, accurate diagnosis and immediate intervention with antibiotics, surgery, and supportive therapy are essential to preventing loss of limb and ensuring full recovery. Tissue biopsy and lab tests are used to identify as many of the organisms present. The patient is started on a broad spectrum antibiotic that will kill as many as possible and prevent further spread of the bacteria. Once the bacteria present is identified, then the patient may be switched to a more specific antibiotic.

Surgery may be needed. The surgeon removes as much of the pus and necrotic (dead) tissue as possible. This procedure is called debridement. In many cases, the process has to be repeated several times (serial debridement).

Along with antibiotics and debridement, there’s a third key part to successful treatment. This is referred to as adjunctive therapy and can include oxygen therapy, intravenous immunoglobulin therapy, and nutritional support.