Necrotising Fasciitis Diabetes
People with diabetes are more prone to certain diseases, one of which is necrotising fasciitis – an aggressive bacterial infection that affects the soft tissues. Necrotising fasciitis must be diagnosed and treated quickly, or life-changing injuries will occur. If no treatment is provided, the condition will certainly be fatal.
What is necrotising fasciitis?
Necrotising fasciitis is a bacterial infection. It arises in the body's deep tissues and fascia (connective tissue). It is considered a rare infection, and it is thought around 500 new cases of necrotising fasciitis occur in the UK each year.
Necrotising fasciitis happens when bacteria get into the body and travel to the deep tissues. Not all bacteria will cause necrotising fasciitis. Examples of bacteria which can lead to necrotising fasciitis include Group A Streptococcus, E.Coli and Klebisella.
Sometimes it is not known how the bacteria gets into the body. But in the majority of cases, the patient will have recently suffered some form of lesion – such as a bite, cut, surgical wound or the insertion of a needle.
Once inside the deep tissues, the bacteria multiply. This process releases a toxin into the body which damages the nearby tissue and blood vessels. Consequently blood cannot reach the tissue and it becomes deficient in oxygen. The cells cannot live with oxygen, so the tissue will soon die. This is called tissue necrosis.
Because the bacteria is multiplying, they are traveling to an ever increasing area of tissue. This means that unless treatment is provided, more and more tissue will die. If left for long enough, the bacteria will damage muscles, organs and also enter the bloodstream. This blood poisoning is very dangerous as it can lead to sepsis, a potentially fatal illness that causes multi-system organ failure.
What is diabetes?
Diabetes is when the pancreas does not produce enough insulin, or the insulin it does produce cannot be absorbed by the body.
Insulin is a hormone which moves glucose from the bloodstream and into the cells. The cells convert glucose into energy, something which we need for every bodily function possible, including movement. Glucose comes from the carbohydrates we eat, and it is also produced by the liver.
Without insulin, the glucose levels in the blood will be very unstable. Furthermore, the glucose will not reach the cells, making the individual very tired. Insulin must therefore be replaced by artificial means – either by injecting insulin, or by taking insulin tablets. For some people who have mild type 2 diabetes, the condition can be controlled through diet and exercise alone.
Why are diabetics at risk of necrotising fasciitis?
People with diabetes are particularly at risk of developing a host of conditions and illnesses, including necrotising fasciitis.
Diabetes sufferers are at risk of necrotising fasciitis due to:
- Immunodeficiency
- Obesity
- Arteriosclerosis
- Insulin injections
- Other complications of diabetes
To understand in greater detail, let us explore each of these risk factors in greater detail.
Immunodeficiency – people with diabetes generally have a weaker immune system, something which can be caused by unstable blood glucose levels. This will make them poor susceptible to bacterial infections like necrotising fasciitis.
Obesity – there are two different forms of diabetes: type 1 and type 2. Type 2 diabetes is associated with poor diet and lack of exercise. It therefore follows that the majority of people with type 2 diabetes are overweight or obese. Necrotising fasciitis is known to be more prevalent in obese patients.
Arteriosclerosis – arteriosclerosis is when fat clogs up the arteries, making them hard and narrow. High blood sugar can make blood vessels inflamed and can also slow down the flow of blood, both of which can lead to arteriosclerosis. When the arteries become hard and narrow, the surrounding tissue will become deprived of blood and oxygen. Tissue that is deficient in blood and oxygen will be vulnerable to infection.
Insulin injections – for necrotising fasciitis to develop, the bacteria must find an opportunity to enter the body. They can do so via a needle wound. If a diabetes sufferer must inject insulin, they leave themselves exposed to the possibility of bacteria entering the needle wound site.
Other complications of diabetes – diabetes is associated with various other health complications that can increase the risk of necrotising fasciitis, including peripheral neuropathy and slow healing wounds (such as bites, cuts and ulcers).
Diagnosing a diabetes patient with necrotising fasciitis
Necrotising fasciitis will cause the following symptoms:
- A severe pain at the site of infection that has no obvious cause, or is disproportionate to the injury
- Skin at the site of infection that is red, swollen and hot to touch
- Fever, with chills, shivering and a high temperature
As the infection progresses, the skin will change in appearance. It will become increasingly dark in colour, turning from dark red to purple/black. Blisters can also appear on the skin.
This clinical presentation is key to making an accurate diagnosis. Medical practitioners should recognise the patient's symptoms as being indicative of a severe soft tissue infection. Investigations should be commenced immediately to discover the underlying infection. The best course is to arrange urgent surgical exploration, as this will reveal whether the tissue is indeed necrotic.
Treating necrotising fasciitis in diabetic patients
Once necrotising fasciitis is diagnosed, the patient should undergo emergency debridement surgery. This removes all of the infected tissue. Intravenous antibiotics will also be needed.
Failure to diagnose and treat necrotising fasciitis in diabetes patient
As mentioned above, the diagnosis of necrotising fasciitis depends largely upon doctors recognising the patient's clinical symptoms. If a patient is a diabetic, suspicions of necrotising fasciitis should be especially raised, as diabetes is known to be a risk factor. All this should ensure a speedy diagnosis and emergency treatment.
However, there are times when medical practitioners fail to diagnose and treat necrotising fasciitis in a reasonable timeframe. This will be very dangerous for the patient, particularly if he/she is diabetic, as their immune system will be unable to overcome the infection. It will soon spread to a large area of tissue, which will eventually have to be surgically removed. Even with a delay of just a few hours, the infection can reach the bloodstream, setting off a septic response. This can be fatal.
Legal help for necrotising fasciitis claim
Necrotising fasciitis must be diagnosed and treated within hours of the patient presenting to a doctor or hospital. A failure to do so could amount to medical negligence.
If you have undergone extensive surgical debridement because of necrotising fasciitis and would like to know whether you have been the victim of medical negligence, please get in touch with us today.
Alternatively if your loved one died due to necrotising fasciitis complications, you could be eligible to pursue a claim on their behalf. Contact us to talk to a legal expert today.
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