# Strep bacteria and necrotizing fasciitis: How? **URL:** \ **Category:** Factual Questions\ **Created:** [May 15, 2007, 2:59am UTC](https://boards.straightdope.com/t/strep-bacteria-and-necrotizing-fasciitis-how/404142 "2007-05-15T02:59:52Z")\ **Posts on this page:** 4\ **Page:** 1
**Author:** ![Earl\_Snake-Hips\_Tucker](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/earl_snake-hips_tucker/32/3269_2.png) [@Earl\_Snake-Hips\_Tucker](https://boards.straightdope.com/u/Earl_Snake-Hips_Tucker)\ **Post date:** [May 15, 2007, 2:59am UTC](https://boards.straightdope.com/t/strep-bacteria-and-necrotizing-fasciitis-how/404142/1 "2007-05-15T02:59:52Z")
OK, I’m mostly up to speed with the subject, but some background: A “Discovery Health” program tonight mentioned a case of a man who lost a good bit of the flesh on a leg from necrotizing fasciitis, the result of an ankle injury during a soccer game. There was no indication in the program of the skin actually having been broken. Locally, about fifteen years ago, there were two notable cases: One in which a high-school football player suffered a bruise on his leg. A week or so later, he suddenly got sick and died. Within a year of that, two school kids (in their teens) got into a fight, one of whom got puched in the chest and ending up with a bruise. Within a week, the kid who was punched developed “a fast spreading infection” which killed him quickly. In that case, as well as the local football player, the diagnoses were the same: necrotizing fasciitis. Now, not having access to the autopsy reports or their medical records, or having seen these “bruises” first-hand, I’m assuming that the bacteria was (or “were,” depending on how you look at it) able to establish a beachhead with just a bruise, and not needing the skin to be broken. Is that plausible, and if so, why is bruised, but not broken, tissue more susceptible? ---
**Author:** ![picunurse](https://avatars.discourse-cdn.com/v4/letter/p/7bcc69/32.png) [@picunurse](https://boards.straightdope.com/u/picunurse)\ **Post date:** [May 15, 2007, 4:45am UTC](https://boards.straightdope.com/t/strep-bacteria-and-necrotizing-fasciitis-how/404142/2 "2007-05-15T04:45:16Z")
The skin would have to be broken, but not a gaping wound. I’ve cared for three children whose necrotizing fasciitis started with a chicken pox leision. I’ve also cared for a couple over weight adults who developed a small zit under a fat roll that progressed to NF. I’m guessing, the bruised areas had, what was thought to be, a minor abrasion. It may not even be noticed. ---
**Author:** ![Geek\_Mecha](https://avatars.discourse-cdn.com/v4/letter/g/ecae2f/32.png) [@Geek\_Mecha](https://boards.straightdope.com/u/Geek_Mecha)\ **Post date:** [May 15, 2007, 6:47am UTC](https://boards.straightdope.com/t/strep-bacteria-and-necrotizing-fasciitis-how/404142/3 "2007-05-15T06:47:30Z")
Atul Gawande’s book _Complications_ has a chapter on his firsthand experience with necrotizing fasciitis. The entry point of the bacteria can be something as minor as a mild abrasion, insect bite, or blister. It doesn’t take much, and it’s scary how fast the bacteria can eat away flesh. ---
**Author:** ![gonzomax](https://avatars.discourse-cdn.com/v4/letter/g/e8c25b/32.png) [@gonzomax](https://boards.straightdope.com/u/gonzomax)\ **Post date:** [May 15, 2007, 4:32pm UTC](https://boards.straightdope.com/t/strep-bacteria-and-necrotizing-fasciitis-how/404142/4 "2007-05-15T16:32:10Z")
How common is this getting.? I thought it was very rare.