When the man in his 60s first hurt his leg, he wasn’t too worried about it. He had cut his leg open on the door to his caravan and, like in the past, figured it would heal with no issues. Instead, this seemingly simple injury led to the loss of his leg after he developed a rare “flesh-eating illness” called necrotizing fasciitis.

Consider the Unexpected

As initially reported by Newsweek, the man visited the hospital as his injury worsened. His leg became painful, tender, warm, red, and inflamed. At the hospital, he developed a fever. Doctors, concerned that there was a deeper underlying issue, transferred him to another hospital. It was here that the man’s kidneys failed. Doctors also identified that the man had sepsis. Formerly known as blood poisoning, sepsis occurs when your body doesn’t respond properly to an infection. Sepsis can be serious and life-threatening. Eventually, at a third hospital, the man was diagnosed with necrotizing fasciitis. In an attempt to save the affected leg (and, of course, the man’s life), doctors began treatment right away.

But his infection was trickier than it seemed. In most cases, necrotizing fasciitis is caused by bacteria that enter into the body through cuts, scrapes, or other injuries. Most commonly, A. streptococcus plays a role. This man, however, had an extremely rare case of necrotizing fasciitis resulting from mucormycosis, or a serious fungal infection. Doctors did not know this at the time so they treated the man using surgical wound debridement (by removing dead and infected tissue from the wound). The man required four separate surgical debridement procedures and was given a multitude of antibiotics – but his leg refused to heal. An amputation was required.

After going into hyperkalemic cardiac arrest, multiple organ failure, acute anemia, and coagulopathy, doctors knew that something was wrong. They had treated the necrotizing fasciitis in every way they knew how but there had been no improvements. So they began running additional tests. It’s through this that they finally identified the mucormycosis that had entered into the man’s blood vessels. Antifungal treatment helped the man to fully recover with no long-term health impacts.

In a report about this man, published in BMJ Case Reports, the authors recommend that doctors consider fungal infections as a potential causitive element in necrotizing fasciitis in patients that are not responding well to treatments.

What is Necrotizing Fasciitis?

As explained above, necrotizing fasciitis usually results from bacteria but may occur due to fungal causes. While the bacteria or fungus that causes this rare infection typically enters through a break in the skin, it can also enter through blunt force trauma or similar means. The infection causes soft tissue death. It is important to quickly identify necrotizing fasciitis; it spreads quickly and can be deadly. While anybody can contract necrotizing fasciitis, it is more common in people who are immunocompromised, such as those with liver cirrhosis, cancer, or kidney disease.

Symptoms often begin with:

• A red, inflamed area of skin that grows as the infection progresses
• Severe pain
• Fever

As the infection continues, later symptoms may include:

• Skin blistering or ulceration that may pus or ooze
• Changes in skin color
• Black spots on the skin
• Dizziness
• Fatigue
• Nausea and vomiting
• Diarrhea

Complications may occur from necrotizing fasciitis, such as organ failure, shock, or sepsis. Typically, necrotizing fasciitis is treated with antibiotics and debridement; some patients may also require a blood transfusion.