Tropical Infection – Necrotizing Fasciitis!

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**Warning: Graphic images are contained in this article!**

There are a range of infections that you can get when working in the tropics but one of the worst is Necrotizing Fasciitis.

So, what the heck is Necrotizing Fasciitis?

Necrotizing fasciitis (NECK-re-tie-zing FASH-e-i-tis) is a rare bacterial infection that spreads quickly in the body and can cause death.

Necrotizing fasciitis is rarely contagious. It is very rare for someone with necrotizing fasciitis to spread the infection to other people.

There are many types of bacteria that can cause the “flesh eating disease” called necrotizing fasciitis. Public health experts believe group A Streptococcus (group A strep) are the most common cause.

How you become infected!

The bacteria most commonly enter the body through a break in the skin, including:

  • Cuts and scrapes
  • Burns
  • Insect bites
  • Puncture wounds
  • Surgical wounds

However, people can also get necrotizing fasciitis after an injury that does not break the skin (blunt trauma).

The most common way on commercial vessels is by a puncture wound.

The infection often spreads very quickly. Early symptoms of necrotizing fasciitis can include but are not limited to:

  • 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

Dealing with necrotizing fasciitis!

Common sense and good wound care are the best ways to prevent a bacterial skin infection.

  • Clean all minor cuts and injuries that break the skin (like blisters and scrapes) with soap and water.
  • Clean and cover draining or open wounds with clean, dry bandages until they heal.
  • See a doctor for puncture and other deep or serious wounds.
  • Wash hands often with soap and water or use an alcohol-based hand rub if washing is not possible.
  • Care for fungal infections like athlete’s foot.

Necrotizing fasciitis is a very serious illness that requires care in a hospital. Antibiotics and surgery are typically the first lines of defence if a doctor suspects a patient has necrotizing fasciitis.

Since necrotizing fasciitis can spread so rapidly, patients often must get surgery done very quickly. Doctors also give antibiotics through a needle into a vein (IV antibiotics) to try to stop the infection.

Sometimes, however, antibiotics cannot reach all of the infected areas because the bacteria have killed too much tissue and reduced blood flow. When this happens, doctors have to surgically remove the dead tissue. It is not unusual for someone with necrotizing fasciitis to end up needing multiple surgeries. In serious cases, the patient may need a blood transfusion.

Necrotizing fasciitis can lead to sepsis, shock, and organ failure. It can also result in life-long complications from loss of limbs or severe scarring due to surgically removing infected tissue.

Even with treatment, up to 1 in 3 people with necrotizing fasciitis die from the infection. Six out of every 10 people who get both necrotizing fasciitis and streptococcal toxic shock syndrome at the same time die from their infections.

Streptococcal toxic shock syndrome is another very serious illness caused by group A strep. It causes the body to go into shock and involves low blood pressure and multiple organ failure.

You may have heard that you can get Vibrio infection from eating raw or undercooked oysters and other seafood. But did you know you can also get a Vibrio infection through an open wound? This can happen when a wound comes into contact with raw or undercooked seafood, its juices, or its drippings or with saltwater or brackish water and can lead to necrotizing fasciitis

One species, Vibrio vulnificus, can cause life-threatening wound infections. Many people with Vibrio vulnificus infection require intensive care or limb amputations, and about 1 in 5 people with this infection die, sometimes within a day or two of becoming ill.

Shorlink’s Recommendation

Treat all puncture wounds quickly, don’t think they are just a small scratch, and everything will be OK because often it’s too late when it surfaces.


All commercial vessels have the appropriate drugs onboard to deal with necrotizing fasciitis before it takes hold so tell the Master and have your wounds tended too quickly!