Skip to main content

Necrotizing Soft Tissue Infection / Necrotizing Fasciitis

What Is Necrotizing Soft Tissue Infection (NSTI) / Necrotizing Fasciitis (NF)?

NSTI or NF is known as a flesh-eating disease. NSTI infects the tissue covering your muscles and the tissue under all the skin layers (subcutaneous). The infection causes these tissues to die (necrosis). NSTI can spread from there to your muscles and skin. People with a weakened immune system can be at greater risk of developing this condition.

Fournier’s Gangrene (FG) is a type of necrotizing soft tissue infection in the groin region.

Having a flesh eating bacteria is a medical emergency. If your doctor suspects you have this disease, they will admit you to a hospital for testing as soon as possible.

Causes of NSTI & Necrotizing Fasciitis

NSTI is caused by bacteria that produces toxins, which damage the soft tissue. These bacteria include the following:

  • Streptococcus: A type of bacteria that causes strep infections, like strep throat, scarlet fever, impetigo, and others.
  • Staphylococcus: Bacteria found on your skin or in your nose. Most of the time, these bacteria cause no problems or minor skin infections (called staph infections). However, staph infections can turn deadly if the bacteria invade deeper into your body or into your bloodstream.
  • Enterococcus: Bacteria that live in your intestines or genital tract. They can lead to urinary tract infections, wound infections, and endocarditis.
  • Bacteroids

A deep wound that gets contaminated could lead to a soft tissue infection. Risk factors include these conditions or characteristics:

  • Diabetes mellitus
  • Insect bites
  • Burns
  • Puncture wounds or other injuries
  • Intravenous drug use
  • Age greater than 50 years
  • Hypertension
  • Malnutrition/obesity

NSTI & Necrotizing Fasciitis Signs & Symptoms

Signs and symptoms of soft tissue infection include these:

  • Fever
  • Fatigue
  • Pain and swelling of the skin in a particular area, worse than you might normally expect
  • Rash
  • Dusky discoloration and blistering (may occur in late stages) 

Treatment for NSTI & Necrotizing Fasciitis

Treatment for NSTI includes surgery, wound care, or medical management, such as antibiotics and fluids.


Doctors may perform a surgical procedure to completely remove all dead tissue and to prevent the infection from spreading. You may need multiple surgeries to remove all of the infection.

Wound Care

Wound care and dressing changes are done to make sure the wound stays clean. To prevent any additional infections, the team will use these hygiene methods:

  • Washing hands when entering and exiting the patient’s room
  • Wearing gowns, gloves, and masks (Personal Protective Equipment, or PPE)
  • Restricting who can visit the patient
  • Caring for the dermal skin wounds (wound care)
  • Practicing personal hygiene 

Medical Management

Patients may require multiple procedures or medications to manage the infection. These may include the following: 

  • Having an IV to keep hydrated
  • Taking antibiotics to control infection
  • Breathing through a temporary tube to maintain the patient’s airway
  • Taking medications for blood pressure
  • Replacing electrolytes (potassium, sodium, phosphorus, and the like)
  • Managing glucose or blood sugar

Pain Control & Recovery

Comfort is a top priority for our patients. The treatment team will give you pain medications as you need them.

The length of your hospital stay depends on how extensive the disease is. 

Helping a Family Member?

Before the patient can go home, they need to reach specific goals. The treatment team will talk about these goals throughout your stay and will evaluate your progress frequently.

Find a Burn Specialist

Verified Burn Center Experts

Why does it matter that we are a verified burn center? The American Burn Association and the American College of Surgeons designed a rigorous review program that ensures verified centers offer the best care for their patients. This includes the whole patient experience from the time of injury through rehabilitation.

It also means we meet the highest quality of care available because we meet these high quality standards. The standards are for personnel qualifications, facilities resources, organizational structure, and medical care services.

ABA-Verified Burn Center logo