rare infection of the deeper layers of skin and subcutaneous tissues, spreads across the fascial plane within the subcutaneous tissue rapidly and
destroys the body's soft tissue. Suspect organisms include: Group A streptococcus, Streptococcus pyogenes (most common infection), Staphylococcus
aureus, Clostridium perfringens, Bacteroides fragilis, Aeromonas hydrophila,

Most cases occur randomly and are not linked to similar infections in others. The most common way of getting necrotizing fasciitis is when the bacteria
enter the body through a break in the skin, like a cut, scrape, burn, insect bite, or puncture wound. Most people who get necrotizing fasciitis have other
health problems that may lower their body's ability to fight infection. Some of these conditions include diabetes, kidney disease, cancer, or other
chronic health conditions that weaken the body's immune system.

If you're healthy, have a strong immune system, and practice good hygiene and proper wound care, your chances of getting necrotizing fasciitis are
extremely low.

In cases of necrotizing fasciitis, bacteria spread rapidly once they enter the body. They infect flat layers of membranes known as the fascia.  These are
connective bands of tissue that surround muscles, nerves, fat, and blood vessels. The infection also damages tissues next to the fascia.

Necrotizing Fasciitis Symptoms Can Often Be Confusing

The symptoms often start within hours after an injury and may seem like another illness or injury. Some people infected with necrotizing fasciitis may
complain of pain or soreness, similar to that of a "pulled muscle." The skin may be warm with red or purplish areas of swelling that spread rapidly.
There may be ulcers, blisters or black spots on the skin. Patients often describe their pain as severe and way out of proportion to how the painful area
looks when examined by a doctor. Fever, chills, fatigue (tiredness) or vomiting, due to the toxic compounds released by the bacteria, may follow the
initial wound or soreness. These confusing symptoms may delay a person from seeking medical attention quickly. Persons with these symptoms after a
wound, must see a doctor right away.

Prompt Treatment Needed for Necrotizing Fasciitis

The first line of defense against this disease is strong antibiotics injected or given intravenously. Since the bacterial products and toxins can destroy
soft tissue and reduce blood flow, antibiotics may not reach all of the infected and decaying areas. This is why the rapid surgical removal of dead tissue
– in addition to antibiotics – may be critical to stopping the infection.

CDC Tracks Necrotizing Fasciitis due to the Most Common Cause

CDC tracks specific infections in the US, including necrotizing fasciitis caused by group A strep, with a special system called Active Bacterial Core
surveillance (ABCs).

Active Bacterial Core surveillance  is an important part of CDC's Emerging Infections Programs network (EIP), a collaboration among CDC, state health
departments, and universities. By sharing this kind of information in a timely way, public health professionals can stay connected and look for trends in
rising cases. Each year in the US, there are about 650-800 cases of necrotizing fasciitis caused by group A strep; this is likely an underestimation as
some cases are probably not reported. According to ABCs data, the number of annual infections does not appear to be rising.
Necrotizing fasciitis (NF),
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