Necrotizing Fasciitis: Causes, Symptoms, and Treatment
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Necrotizing Fasciitis?
Emergency doctors, surgeons, and infectious disease doctors (doctors who treat infections) usually treat necrotizing fasciitis in the hospital. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is necrotizing fasciitis?
Necrotizing fasciitis is a rare but serious bacterial infection. Many people call it flesh-eating disease. It destroys deep soft tissues.
It can develop very quickly into a life-threatening emergency. It can affect any part of the body. It most often affects the arms and legs, especially the legs.
Symptoms
Early symptoms can include:
- A red, warm, or swollen area of skin that spreads quickly.
- Fever.
- Severe pain, including beyond the red, warm, or swollen area.
The pain is usually out of proportion to how the skin looks. The infection can spread under the skin. The top layer of skin may look less affected.
Later symptoms can include:
- Changes in skin color.
- Ulcers, blisters, or black spots on the skin.
- Pus or oozing from the infected area.
- Diarrhea or nausea.
- Dizziness.
- Fatigue, which means feeling very tired.
Causes and who gets it
Many types of bacteria can cause necrotizing fasciitis. Experts believe group A strep bacteria are the most common cause.
The bacteria most often enter the body through a break in the skin. This can include:
- Burns.
- Cuts and scrapes.
- Insect bites.
- Puncture wounds, including those from intravenous (IV) drug use.
- Surgical wounds.
People can also get it after blunt trauma. This is an injury that does not break the skin.
Anyone can get necrotizing fasciitis, although it is rare. Most people who get it have other health problems. These may lower the body's ability to fight infections. These include cancer, cirrhosis (scarring of the liver), diabetes, and kidney disease. Corticosteroid medicine has also been shown to raise the risk.
How doctors diagnose it
Many infections look like necrotizing fasciitis in the early stages. This can make diagnosis difficult. Doctors can diagnose it with:
- Biopsies, which are tissue samples.
- Bloodwork for signs of infection and muscle damage.
- Imaging, such as a CT scan, MRI, or ultrasound of the damaged area.
Treatment must start as soon as possible. Doctors may not wait for test results if they think a patient might have it. Imaging should never delay surgery to explore the area.
Treatment
Necrotizing fasciitis is a very serious illness that requires hospital care. Antibiotics and surgery are typically necessary.
Doctors give antibiotics through an IV, which lets medicine flow into a vein. Sometimes antibiotics cannot reach all the infected areas. The bacteria have killed too much tissue and reduced blood flow. Then doctors must surgically remove the dead tissue.
The main treatment is early, aggressive surgery to remove dead tissue. Patients often must get surgery quickly. It is not unusual to need more than one surgery. In serious cases, a blood transfusion may be needed.
Some people lose a limb. Amputation is a common complication. Removing infected tissue can also leave life-long problems, such as severe scarring.
When to see a doctor
Call 911 or go to the emergency room right away if you have a red, warm, or swollen area of skin that spreads quickly, fever, or severe pain. People with this infection need immediate hospital care.
Speak with a health care provider if you have concerns about necrotizing fasciitis.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. This infection needs hospital care. After a hospital stay, a direct primary care doctor can help with follow-up visits. They can also coordinate care with specialists.
Common questions
Is necrotizing fasciitis life threatening?
Yes, it can be. It can develop very quickly into a life-threatening emergency. Even with treatment, up to 1 in 5 people died from the infection. Patients may quickly develop sepsis, shock, organ failure, and death.
Do people with necrotizing fasciitis need surgery?
Usually, yes. Antibiotics and surgery are typically necessary. Many people need more than one surgery.
Is necrotizing fasciitis contagious?
It depends. Most cases happen randomly. Less serious group A strep infections can turn into it. Those bacteria are contagious.
How can people lower the spread of group A strep bacteria?
Good hand hygiene and respiratory etiquette help reduce the spread.
Sources
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
